Articles: intensive-care-units.
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Critical care medicine · Jun 1998
Comparative StudySeptic shock: an analysis of outcomes for patients with onset on hospital wards versus intensive care units.
To determine if early interventions for septic shock were associated with reduced mortality. ⋯ The data suggest that for patients with septic shock on wards, there were clinically important delays in transfer of patients to the ICU, receipt of intravenous fluid boluses, and receipt of inotropic agents. However, the most powerful predictors of mortality were APACHE II scores and bloodstream infection with Candida species.
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Respir Care Clin N Am · Jun 1998
ReviewHumidification practices in the Adult Intensive Care Unit, Prince of Wales Hospital.
In the Adult Intensive Care Unit of The Prince of Wales Hospital, Sydney, Australia, inspiratory gas is humidified to saturation at 37 degrees C. This stops the buildup of dried sputum within the endotracheal tubes and thus prevents blocked tubes and the increased resistance caused by partial obstruction. Inspiratory and expiratory hose heater wires are used to produce a completely dry circuit, allowing the elimination of water traps and circuit support arms without the resistance of a heat and moisture exchanger.
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Eur. J. Clin. Microbiol. Infect. Dis. · Jun 1998
Bacteraemia in the adult intensive care unit of a teaching hospital in Nottingham, UK, 1985-1996.
Bacteraemia is an important cause of morbidity and mortality in the intensive care unit. In this study the distribution of organisms causing bacteraemic episodes in patients in the adult intensive care unit of a large teaching hospital was determined. Particular emphasis was placed on the type of organisms isolated from community- and hospital-acquired bacteraemia, the suspected source of infection, the possible risk factors associated with bacteraemia, and outcome. ⋯ The overall mortality related to bacteraemia and candidaemia was 44.4%. Surveillance of bacteraemia in the intensive care unit is important in detecting major changes in aetiology, e.g., the increasing incidence of gram-positive bacteraemia, the emergence of methicillin-resistant Staphylococcus aureus in 1995, and the emergence of Enterobacter cloacae. It is of value in determining empirical antimicrobial therapy to treat presumed infection pending a microbiological diagnosis and in directing the development of guidelines for infection prevention, e.g., guidelines for central venous catheter care.
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We assessed the hourly occupancy of our intensive care unit by high dependency patients over an 8-week period using the criteria established by the Working Group on Guidelines on Admission to and Discharge from Intensive Care and High Dependency Units published by the National Health Service Executive. High dependency patients accounted for 1914 bed hours (21.6%) out of a potential available total of 8880 hours. Measurement of Therapeutic Intervention Scoring System points and Acute Physiology and Chronic Health Evaluation II scores confirmed that categorising patients according to the new guidelines produced significantly different populations of patients. ⋯ Calculating bed occupancy with different definitions for the whole of our intensive care unit population during the 8 weeks revealed a range of occupancies between 85.3% and 107.3%. We recommend the intensive care unit bed occupancy should be calculated in a standard manner nationally to allow comparison between units. We suggest that hourly occupancy be adopted as the universal method.
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Anaesth Intensive Care · Jun 1998
Australian Incident Monitoring Study in intensive care: local unit review meetings and report management.
The Australian Incident Monitoring Study in the intensive care unit (AIMS-ICU) is a national study established through nursing and medical collaboration to develop, introduce and evaluate an anonymous voluntary incident reporting system. To ensure incident monitoring results in improved patient safety, it is essential that reported incidents are followed up regularly. Local unit review meetings are an effective forum for discussion and review of reports amongst a wide group of practitioners from the intensive care unit (ICU). ⋯ Ongoing momentum of the project is assisted by highlighting its positive contributions to patient care and safety via newsletters, poster displays and targeted correspondence. New staff require orientation to the reporting system and assurance regarding safety of data. The emphasis must focus on the system, not the individual.