Articles: patients.
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To review the management of the difficult airway in the intensive care unit patient. ⋯ The principles of difficult airway management, including a back-up plan and calling for assistance early, hold true in the intensive care setting as much as in any other clinical setting. It is vital that clinicians develop their own difficult airway algorithm based on their training and experience.
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To determine the perceptions of health care professionals and service providers with regard to emergency department (ED) overcrowding, including definitions of overcrowding, characteristics of an overcrowded ED, and causes of overcrowding, and secondarily to solicit potential solutions to the problem. ⋯ Qualitative studies of this complex issue can identify and describe complex interactions in real-world settings. The findings of such studies can lead to quantitative studies involving objective measurement.
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To review the management of persistent hypertension and hypertensive crisis in the critically ill patient. ⋯ A mean arterial pressure in the critically ill is often tolerated up to a value of 135 mmHg for some hours. However in some disorders (e.g. dissecting aortic aneurysm, cardiac failure, angina, acute myocardial infarction, pre-eclampsia or eclampsia and following cardiac, vascular or cerebral surgery) a mean arterial blood pressure of 90 mmHg or greater should be treated urgently.
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Review of published research indicates the need to better incorporate patient and caregiver perceptions when providing end-of-life (EOL) care. Although considerable research regarding patient and caregiver experience of EOL has been done, little research has studied patients, caregivers, and clinicians as a connected system. ⋯ Awareness of these crucial patient and caregiver EOL issues and expectations and how they differ from clinician perspectives can assist clinicians to appropriately explore and address patient/caregiver concerns and thereby provide better quality EOL care.
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Discuss and summarize recent published literature related to the use of 'blood substitutes' in cardiac surgery patients. ⋯ One hemoglobin-based oxygen carrier (Hemopure) has been approved for use in humans in South Africa as well as another hemoglobin-based oxygen carrier (Gelenpol) and a perfluorocarbon (Perfluoron) in Russia. Phase III trials in Europe and North America will be concluded very soon. We anticipate seeing one or two products approved in North America and Europe by the year 2003/2004.