Articles: intensive-care-units.
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A special emergency ward for paediatric patients was established at the University Hospital in Nantes on November 7, 1990. Both medical and surgical patients less than 15 years, 3 months of age are admitted. The initial organization of the ward (facilities personnel, on call duty) are described for the emergency paediatric surgery unit. ⋯ During this period, 4,438 children were referred to the emergency ward and 2,905 (64.8%) involved a surgical pathology. The epidemiological characteristics of the patients (age, geographic origin, day and hour of admission), the causal pathology, the examinations and procedures performed, and outcome (length of stay in the ward long-term outcome) were studied. Based on these results, the authors analyzed the factors leading to dysfunction and proposed improvements in the organization of this emergency ward.
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Comparative Study
Comparison of APACHE II and III scoring systems for mortality prediction in critical surgical illness.
To determine whether the Acute Physiology and Chronic Health Evaluation III (APACHE III), an updated version of APACHE II that contains a larger number of postoperative patients in the normative database, offers better prediction in critical surgical illness. ⋯ In institutions or groups of patients where APACHE II underestimates mortality, APACHE III may be corrective. However, the differences are subtle and may be difficult to detect in smaller studies.
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To test the hypothesis that improvements in intraoperative and perioperative critical care are resulting in an improved outcome after intraoperative cardiac arrest. ⋯ Survival from an intraoperative cardiac arrest in a noncardiothoracic surgical patient is much improved over rates in historical controls who experienced in-hospital and out-of-hospital cardiac arrest. Rapid identification and aggressive correction of mechanical and metabolic derangements is warranted.
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The level of contamination of stethoscopes used in a neonatal intensive care unit was studied, along with the practices used for cleaning these items. A policy of alcohol cleaning was introduced and the effect of this change on the level of bacterial growth was observed after a six-week period. It was found that 71% of stethoscopes had a significant bacterial growth and that this was reduced to 30% after the cleaning procedure change (P < 0.05). Stethoscopes and other equipment are a potential source of nosocomial infection on the neonatal intensive care unit.