Articles: intensive-care-units.
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The Journal of pediatrics · Jun 1996
Resource consumption and the extent of futile care among patients in a pediatric intensive care unit setting.
To estimate resource consumption and the extent of futile care among patients admitted to the pediatric intensive care unit (PICU). ⋯ Despite our use of broad definitions of medical futility, relatively small amounts of resources were used in futile PICU care. This suggests that attempts to reduce resource consumption in the PICU by focusing on medical futility are unlikely to be successful.
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Anaesth Intensive Care · Jun 1996
The Australian Incident Monitoring Study in Intensive Care: AIMS-ICU. An analysis of the first year of reporting.
The AIMS-ICU project is a national study set up to develop, introduce and evaluate an anonymous voluntary incident reporting system for intensive care. ICU staff members reported events which could have reduced, or did reduce, the safety margin for the patient. Seven ICUs contributed 536 reports, which identified 610 incidents involving the airway (20%), procedures (23%), drugs (28%), patient environment (21%), and ICU management (9%). ⋯ No ill effects or only minor ones were experienced by most patients (short-term 76%, long-term 92%) as a result of the incident. Multiple contributing factors were identified, 33% system-based and 66% human factor-based. Incident monitoring promises to be a useful technique for improving patient safety in the ICU, when sufficient data have been collected to allow analysis of sets of incidents in defined "clinical situations".
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To identify the frequency, outcome, and factors associated with unplanned endotracheal extubation (UE) in the intensive care unit (ICU). ⋯ Patients should be observed closely after unplanned extubation, although many may not require reintubation. Reintubation can be quite difficult, necessitating highly skilled airway management. Attention to associated risk factors may decrease the incidence of both accidental and self-extubation.
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Intensive care medicine · May 1996
The effect of casemix adjustment on mortality as predicted by APACHE II.
To describe the effect of casemix on mortality as predicted by APACHE II scoring. ⋯ APACHE II did not accurately adjust for casemix in our data. Unless account is taken of differences in casemix, using mortality ratios to compare ICU is likely to be inaccurate and misleading.