Crit Care Resusc
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To test whether applying a continuous riskadjusted charting method, using an exponentially weighted moving average (EWMA) chart, would have been useful for monitoring outcomes of patients admitted to the intensive care unit at Bundaberg Base Hospital, Queensland, between November 2000 and December 2005. ⋯ Continuous monitoring of outcomes using an EWMA chart may have advantages over other techniques. Had data been available, analysis with an EWMA chart might have prompted review of processes and outcomes among patients at Bundaberg Base Hospital ICU.
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Pulmonary injury from smoke inhalation is common in burn victims, significantly contributing to the morbidity and mortality of fire-related injuries. The impacts of improvement in other aspects of burn care have not been mirrored in treatment of smoke inhalation. Smoke is heterogeneous and unique to each fire; it comprises particulates, respiratory irritants and systemic toxins as well as heat, all contributing to the pathological insult. ⋯ Many promising treatments are currently under investigation. The therapeutic strategy of decontaminating the lungs early after smoke exposure to prevent inhalation injury has received little attention and may be of significant value. This could potentially utilise amphoteric, hypertonic chelating agents developed for topical and ocular chemical exposures.
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Multicenter Study
Venous thromboembolism prophylaxis in the critically ill: a point prevalence survey of current practice in Australian and New Zealand intensive care units.
Critically ill patients are at high risk of morbidity and mortality caused by venous thromboembolism (VTE). In addition to premorbid predisposing conditions, critically ill patients may be exposed to prolonged immobility, invasive intravascular catheters and frequent operative procedures, and further may have contraindications to pharmaceutical prophylactic measures designed to attenuate VTE risk. There are limited data describing current VTE prophylaxis regimens in Australia and New Zealand. ⋯ We observed a high prevalence of VTE prophylaxis, with many critically ill patients receiving two or more modalities of prophylaxis. These results show that the potential risk of VTE in critically ill patients is recognised in Australia and New Zealand, and strategies to mitigate this serious complication are widely implemented.
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To describe the current utilisation and outcomes for patients receiving decompressive craniectomy (DC) for acute non-trauma-related indications. ⋯ DC has the potential to save lives, but also the potential to leave survivors in a severely debilitated state. The place of DC in managing patients with severe intracranial hypertension due to non-trauma related causes is yet to be definitively established.
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To identify factors associated with the triage decision for patients classified as Society of Critical Care Medicine (SCCM) Triage Priority 3, and their outcomes. ⋯ For SCCM Triage Priority 3 patients, postoperative status and better physician-predicted prognosis correlated with ICU admission. Patients had lower medium-term survival if they were denied ICU admission, or had higher MPMII0-predicted mortality, or renal disease as the admission diagnosis.