Articles: intensive-care-units.
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The growing number of technical devices in ICUs makes noise exposure a major stressor. The purpose of this study was to assess noise levels during routine operation in our ICU. ⋯ During the day and at night SPL always surpasses the permissible noise exposure for 24 h of 45 db(A) recommended by the US Environmental Protection Agency. Alarms cause the most irritating noise. Hospital management should pay attention to internal noise, and SPL should be measured routinely.
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The frequency of adult surgical and medical intensive care unit (ICU) admissions related to substance abuse was determined at a large community, trauma, and tertiary referral hospital. Of 435 ICU admissions, 14 percent (95 percent confidence interval [CI], 5 to 23 percent) were tobacco related generating 16 percent of costs, 9 percent (95 percent CI, 0 to 18 percent) were alcohol related generating 13 percent of costs, and 5 percent (95 percent CI, 0 to 14 percent) were illicit drug related generating 10 percent of costs. In all, 28 percent (95 percent CI, 20 to 36 percent) of ICU admissions generating 39 percent of costs were substance abuse related. ⋯ Frequency of substance abuse-related admission was linked with the patient's insurance status (Medicare, private insurance, uninsured). In the uninsured group, 44 percent of admissions were substance abuse related (95 percent CI, 35 to 52 percent), significantly higher than in the private insurance and Medicare groups, and generating 61 percent of all ICU costs in the uninsured group. Large fractions of adult ICU admissions and costs are substance abuse related, particularly in uninsured patients.
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Kangaroo Care--skin-to-skin contact between parent and baby--is becoming a popular adjunct to the routine, technology-driven care provided to premature babies in neonatal intensive care units (NICUs) across the country. Research suggests that Kangaroo Care is safe and that it is therapeutic for the infant and parent alike. The purpose of this article is to review the Kangaroo Care Program at Brigham and Women's Hospital and to illustrate how it meets the needs of parents of premature infants.