Articles: intensive-care-units.
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AACN Clin Issues Crit Care Nurs · May 1991
Emergent admission to the pediatric intensive care unit: parental concerns.
To identify parental concerns when a child is suddenly admitted to the pediatric intensive care unit, 17 parents of ten critically ill children were interviewed using a structured format between 20 and 36 hours after admission about their concerns around the time of admission and at the time of interview using the Parental Concerns Scale. The individual concern items receiving the highest ratings were the child's survival, the possibility of mental or physical impairment, the child's diagnosis, and the amount of pain experienced by the child. Total concern scores decreased over time for both mothers and fathers when the child's prognosis was good and, for mothers only, when the child had an infectious illness rather than accidental injuries. Implications for nursing practice are discussed.
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Journal of anesthesia · Apr 1991
Accidental extubations during respiratory management in a children's hospital.
An investigation was conducted on the frequency of accidental extubations at Shizuoka Children's Hospital during the past 12 years. The study was performed on 150 randomly selected patients who received respiratory support for more than 24 hr. Fifteen accidental extubations occurred in 9 patients. ⋯ It became clear that more immature babies were more likely to suffer accidental extubation, perhaps reflecting the fact that most of the immature babies in the NICU were intubated orally, and that a larger proportion of them required a longer period of respiratory support. Therefore, early weaning from respiratory support is recommended if it is possible. In conclusion, increased surveillance and more secure methods of taping of endotracheal tubes are crucial for preventing life-threatening accidental extubations during respiratory support.
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Critical care medicine · Apr 1991
Objective assessment of changing mortality risks in pediatric intensive care unit patients.
To develop and validate a mortality risk predictor based on physiologic data that estimates daily the probability of a patient dying within the next 24 hrs as that probability changes with disease and recovery. ⋯ The predictor is valid for assessing the 24-hr mortality risk in pediatric ICU patients hospitalized in other tertiary care institutions, different from those used for predictor development. The predicted mortality risks allow prospective patient stratification into risk groups. The ability of this predictor to follow risk changes over time expands its applicability over static predictors by enabling the charting of patient courses, and permitting ICU efficiency analysis.
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A study of 233 neonatal deaths out of 30910 livebirths over an 8 year period in the Toa Payoh Hospital is done. The Hospital has since ceased providing obstetric and neonatal intensive services from April 1990 due to restructuring of hospital care. The Neonatal Mortality Rates (NNMR) from 1982-1989 ranged from 6.52 to 9.55 and there was no significant fall in trend (p = 0.13). ⋯ Improvement in VLBW and RDS management has not contributed to a significant decline in NNMR. It is observed that more VLBW babies were born during this 8 year period (p = 0.01) especially so in the less than 1000 gm group (p = 0.0005) and the survival of VLBW babies has improved (45.5% to 75.8% alive) as a result of advances in neonatal intensive care. The reasons for increase in incidence of VLBW births in the past few years are not known.(ABSTRACT TRUNCATED AT 250 WORDS)
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The purpose of this study was to characterize the hospitals of the municipality of São Paulo, with or without Intensive Care Units (ICU). It was analysed the maintainers entities of these hospitals, the type of assistance, and their geographic localization in accordance to the proposition of SUDS (Unificated and Decentralized System of Health). The results demonstrated that there is an uneven distribution of those resources with concentration in central areas, predominance of general and private hospitals and the use of those resources have been difficult to population.