Articles: intensive-care-units.
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Monitoring plays an essential role in the management of critically ill children, although continuous observation along with frequent clinical examination remains the best readily available monitor. Unfortunately, human beings do not have the capability of a prolonged, uninterrupted attention span and nurses often have multiple tasks assigned that limit their ability for continuous observation. Furthermore, some information cannot be obtained accurately by clinical examination alone, e.g. oxygen saturation, ICP, etc. Therefore, it is important to understand the principles and practical points to be able to use these monitors, and first rule out malfunction, disconnection, or improper electrode placement when abnormal reading appear on these monitors before initiating clinical intervention on a patient.
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Critical care clinics · Jan 1993
ReviewEthical considerations in the treatment of AIDS patients in the intensive care unit.
The treatment of patients with AIDS in the ICU presents the clinician with special challenges. The admission policies of ICUs are examined, and the authors suggest ways in which ethical difficulties may be minimized. A new concept of futility is suggested, which considers both the patient's holistic needs together with his or her immediate medical prognosis. Changes in the law regarding patient choice are discussed.
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To determine what data are currently being collected at the critical care bedside, the role of flow sheets in storing these data, and what other forms and locations are used to store critical care data. ⋯ The lack of standardization regarding key information that should be collected and archived in critical care units identifies important risk management and quality assurance issues. There is a need for agreement on what information should be collected and maintained at the bedside in order to provide quality patient care.
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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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Critical care medicine · Jan 1993
Iatrogenic complications in adult intensive care units: a prospective two-center study.
a) To evaluate the frequency, types, severity, and morbidity of iatrogenic complications; b) determine associated factors that favor iatrogenic complications; and c) suggest new or more efficient protective measures that may be taken to improve patient safety. ⋯ Major iatrogenic complications were frequent, associated with increased morbidity and mortality rates, related to high or excessive nursing workload, and were often secondary to human errors. To improve patient safety in our ICUs, preventive measures should be targeted primarily on the elderly and the most severely ill patients. Special attention should be given to improving the organization of workload and training, and promoting wider use of noninvasive monitoring.