Crit Care Resusc
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Comparative Study
Outcomes of patients admitted to tertiary intensive care units after interhospital transfer: comparison with patients admitted from emergency departments.
To compare outcomes of patients admitted to tertiary-level intensive care units after interhospital transfer (IHT) with those of similar patients admitted from the emergency department (ED). ⋯ Patients admitted to an ICU from another hospital have higher hospital mortality and longer stay than those admitted from the ED, with the differences varying between diagnoses. These differences are important considerations for resource allocation and triage, and as a measure of quality.
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Comparative Study
Observational study of patients admitted to intensive care units in Australia and New Zealand after interhospital transfer.
To describe the demographics, illness categories and outcomes of adult intensive care unit patients who underwent interhospital transfer (IHT). ⋯ Patients admitted to an ICU after IHT have significant resource implications based on their severity of illness, hospital stay and mortality, and adversely affect ICU capacity for elective and operating theatre admissions. Regional differences and temporal trends have implications for planning of ICU resources and require ongoing surveillance.
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Case Reports
Independent lung ventilation in the intensive care unit: desperate measure or viable treatment option?
Independent lung ventilation is often used intra-operatively but has also been used in intensive care in a variety of clinical situations. Ventilating lungs independently of each other may be life-saving when a lung abnormality is predominantly unilateral. We successfully used independent lung ventilation in two patients, who benefited from anatomical and physiological separation of their lungs. These cases remind intensivists that independent lung ventilation is a viable option to be considered in cases of pulmonary abnormality when conventional mechanical ventilation is deleterious.
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Multicenter Study
Terror Australis 2004: preparedness of Australian hospitals for disasters and incidents involving chemical, biological and radiological agents.
To assess the level of preparedness of Australian hospitals, as perceived by senior emergency department physicians, for chemical, biological and radiological (CBR) incidents, as well as the resources and training available to their departments. ⋯ This survey raises significant questions about the level of preparedness of Australian EDs for dealing with patients from both conventional and CBR incidents. Hospitals need to review their plans and functionality openly and objectively to ensure that their perceived preparedness is consistent with reality. In addition, they urgently require guidance as to reasonable expectations of their capacity. To that end, we recommend further development of national standards in hospital disaster planning and preparedness.
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Comparative Study
Hypothermia on arrival in the intensive care unit after surgery.
Minimising perioperative hypothermia is a priority for anaesthetists. However, there are few studies of postoperative hypothermia in intensive care units. We tested the hypotheses that many patients arrive in the ICU with hypothermia and that patients are warmer after cardiac surgery than after non-cardiac surgery. ⋯ Hypothermia is common among postoperative patients admitted to our ICU. We suggest that ICU staff should routinely expect to actively warm postoperative patients, particularly after non-cardiac surgery, and should have sufficient resources to do so.