Crit Care Resusc
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High-flow nasal cannula (HFNC) therapy is increasingly used in paediatric intensive care unit (PICU) patients, despite a paucity of studies. We describe its use over the 3 years since its implementation in our tertiary intensive care unit. ⋯ HFNC therapy was successful in most patients. Most failures occurred within 8.25 hours. Use of HFNC for heart disease was associated with a high therapy failure rate (50%).
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ICU registrars frequency encounter RRT calls associated with EOLC during their training. Interventions involving EOLC appear to be some of the commonest interventions performed during RRT review. Therefore, training about the assessment an management of such calls should be provided to registrars who participate in RRT calls. The approach outlined here provides a framework for such training.
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Observational Study
Hospital outcomes associated with introduction of a two-tiered response to the deteriorating patient.
Liverpool Hospital introduced the medical emergency team system in 1990 and it has recently been adopted at a national and international level. New South Wales, Australia, has introduced a standardised rapid response system in over 250 acutecare hospitals: the two-tiered (clinical review call [CRC] and rapid response call [RRC]) "between the flags" (BTF) program. ⋯ After introduction of the BTF program, there was a progressive increase in documented CRCs and an increase in RRCs. There was no decrease in cardiac arrests or hospital deaths. RRCs based on objective physiological criteria increased. More research is needed to evaluate two-tiered response systems.