Articles: intensive-care-units.
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Intensive care medicine · Sep 1996
Evaluation of trauma care: validation of the TRISS method in an Italian ICU.
To validate the TRISS method as an audit system on a group of patients with severe trauma admitted to an Italian general intensive care unit (ICU). ⋯ The results of the validation of the TRISS method showed adequate calibration and high discriminatory power in Italian ICU trauma patients also, allowing confidence in the use of this method as an audit tool in our ICU. Some caution is advisable in extending these results to patients with operable intracranial injuries, due to the relatively low number of such cases included in the study.
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Journal of anesthesia · Sep 1996
Clinical evaluation of a new continuous intraarterial blood gas monitoring system in the intensive care setting.
The present study was designed to evaluate a new continuous intraarterial blood gas monitoring system under routine clinical intensive care conditions. Nine mechanically ventilated adult patients were enrolled in this study. A multiparameter intravascular sensor was inserted into the radial or dorsalis pedis artery through a 20-gauge cannula in each patient. ⋯ In clinically important ranges of Po2, less than 200 mmHg in particular, the bias and precision values were -2.25±6.48 mmHg in the range of less than 100mmHg, and 0.98±14.38 mmHg in the range of 100-200 mmHg. Variations of sensor accuracy as a function of elapsed time were within the clinically acceptable range throughout the study period. These findings suggest that this new device is sufficiently useful for routine clinical settings.
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Acta Anaesthesiol Scand · Sep 1996
Age and life-sustaining treatment. Attitudes of intensive care unit professionals.
In Sweden, the official policy is that life-sustaining treatment should not be denied because of chronological age. This policy is also emphasised in a recent official report on priority setting in health care. But is this policy accepted among health care professionals? Do they consider chronological age relevant when decisions to forgo life-sustaining treatment are to be made? ⋯ The results indicate that chronological age is used as a criterion when decisions to forgo life-sustaining treatment are to be made in the ICU. Many health care professionals also believe that chronological age should be used as a criterion. This is clearly discordant with the official policy in Sweden and other countries, which is that age-based rationing is never justified.
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In order to develop strategies to improve high-dependency (HD) patient care, a continuous quality improvement (CQI) study was initiated in August 1994. It sought to establish a system for the collection and evaluation of relevant information concerning medical and nursing management of HD patients. ⋯ The study revealed a low HD bed occupancy rate, inadequate documentation by medical staff of the need for monitoring, and insufficient numbers of nursing personnel specifically educated to care for HD patients. Recommendations include increased consultants surveillance, immediate assessment of HD patients by a medical officer on the ward, a documented plan for monitoring, avoidance of after-hours discharge from operating theatres or intensive care, and the implementation of an education program for HD area nurses.
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Critical care medicine · Sep 1996
Comparative StudyPoor discriminatory performance of the Pediatric Risk of Mortality (PRISM) score in a South African intensive care unit.
The use of the Pediatric Risk of Mortality (PRISM) score or other scoring systems in the intensive care unit (ICU) is of great importance for evaluating the efficacy and efficiency of a particular ICU. However, the PRISM score was developed and validated in the United States and subsequently validated in Europe, but has not been evaluated in a less affluent society. In general, scoring systems should be used only in populations similar to the reference population in which the prediction model was developed. We set out to determine the applicability of the PRISM score at Baragwanath Hospital, South Africa. ⋯ The PRISM score needs to be recalibrated or recalculated for our patient population in view of the high discrepancy and poor discriminatory function shown. Part of the inaccuracy may derive from different demographic characteristics of our ICU population and a different pattern of diseases. It appears that PRISM is not population independent.