Articles: intensive-care-units.
-
Dtsch. Med. Wochenschr. · Jul 1997
[Epidemiological and prognostic data from 2054 patients of an internal medicine intensive care unit].
Computer-based data collection and objective gathering of degree of illness severity and risk of death with a prognostic scoring system make it possible to obtain, in addition to epidemiological and aetiological data, risk-related outcome values for patients in an intensive care unit. ⋯ Most patients in a MICU have underlying cardiac disease. Permanently available neurological consultation is essential. The high hospital death rate for elderly patients and those requiring respiratory support is a problem of disease severity, not of the quality of treatment. The risk of death is high on transfer to a general ward. Determination of the SMI is recommended for internal quality control in an ICU.
-
The provision of intensive care is a perplexing issue for clinicians and the public. Concerns about the apparent lack of beds and the appropriateness of the patients admitted are tempered by the high cost of providing this service. As part of a study commissioned by the UK Department of Health, we tested the hypothesis that there is excess mortality among patients who are refused admission to intensive-care units. ⋯ Although this study is observational and case-mix adjustment is incomplete, we found a higher rate of attributable mortality in patients who were refused intensive care, particularly for emergency cases. We question whether the provision of more beds alone would be a solution and conclude that there is an urgent need for more appropriate admission and discharge criteria.
-
Int J Obstet Anesth · Jul 1997
A survey of facilities for high risk women in consultant obstetric units.
Reports on Confidential Enquiries into Maternal Deaths and the Obstetric Anaesthetists' Association have made recommendations about the provision of staff and facilities in consultant obstetric units. We have carried out a postal survey of all units in the UK concerning provision of recovery facilities, high dependency and intensive care, and anaesthetic staffing. ⋯ In particular, only 62% had a designated and staffed recovery area, only 41% had specific obstetric high dependency beds and there were a number of units with no consultant anaesthetic sessions or trained anaesthetic assistants available around the clock. Despite the practical and financial difficulties in achieving recommended standards, it should be noted that purchasers of health care have been encouraged to ensure that the recommendations are implemented.