Crit Care Resusc
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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.
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Randomized Controlled Trial
Palliative care teams in the intensive care unit: a randomised, controlled, feasibility study.
To determine whether palliative care teams can improve patient, family and staff satisfaction for patients receiving end-of-life care in the intensive care unit and reduce surrogate markers of health care costs. ⋯ This feasibility study was difficult to conduct and did not generate any robust conclusions about the utility of involving palliative care teams in end-of-life care in the ICU. Larger studies are technically possible but unlikely to be feasible.
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To determine the proportion of hospital staff who pass fit tests with each of three commonly used particulate face masks, and factors influencing preference and fit test results. ⋯ A large proportion of individuals failed a fit test with any given mask, and we were not able to identify any factors that predicted mask fit in individuals. Training on mask use improved the rates of adequate fit. Hospitals should carry a range of P2 masks, and should conduct systematic P2 mask training and fit-testing programs for all staff potentially exposed to airborne pathogens.
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Serotonin toxicity secondary to drug therapy, interaction or overdose is an increasing phenomenon worldwide. A proportion of patients require admission to an intensive care unit, but the treatment needed is usually supportive and of short duration. Prolonged ICU admission to control ongoing or long-lasting serotonin toxicity has not been reported previously. ⋯ We review the pharmacological mechanisms that led to prolonged serotonin toxicity in these patients. Predictors for prolonged serotonin toxicity include involvement of irreversible monoamine oxidase inhibitors (MAOIs) or slow-release preparations resistant to the effects of activated charcoal (eg, lithium). We also discuss the implications of prolonged toxicity for critical care management, to maintain optimal patient outcomes.