Rhode Island medical journal (2013)
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Acute kidney injury (AKI) is a common condition amongst critically ill patients in the medical intensive care unit (ICU) and is associated with increased morbidity and mortality. There are several areas of ongoing debate regarding management of AKI, specifically the initiation and timing of renal replacement therapy (RRT). In this review, we aim to concisely discuss epidemiology, current evidence with regards to optimal vascular access, timing of initiation and modality of renal replacement therapy in acute kidney injury in critically ill patients.
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This article summarizes current data and recommendations regarding the care of patients in an intensive care unit (ICU) at the end of life. Through analysis of recent literature and society guidelines, we identified three areas of focus for practitioners in order to deliver compassionate care to patients and their families at this critical time - family communication, caregiver support, and palliative care involvement. Attention to these topics during critical illness may reduce stress-related disorders in both patients and family members, as well as increase satisfaction with the care delivered.
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Our objective was to identify patterns of opioid use among pregnant women enrolled in RI Medicaid. ⋯ Prescription opioid use during pregnancy has increased among women enrolled in RI Medicaid.
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The opioid epidemic presents an urgent public health problem. Rhode Island has enacted comprehensive rules to address primary prevention of opioid overdose. This study evaluates the efficacy of those regulations in altering prescribing behavior, specifically regarding the initial prescription. Using data extracted from the Rhode Island Prescription Drug Monitoring Program (PDMP), before and after the publication of updated acute pain management regulations, we studied the rate of opioid prescribing using statistical process control (SPC) charts and found that the rate of prescribing unsafe doses of opioids, more than 30 morphine milligram equivalents (MMEs) per day or more than 20 doses to opioid naïve patients, decreased significantly.