Articles: intensive-care-units.
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The role chest radiography plays in intensive care units (ICU) is unlike its role elsewhere because in the ICU a patient's underlying disease is usually known. Furthermore, additional diseases that develop in the ICU-such as pneumonia, hemorrhage, edema, lung collapse and effusion-often are radiographically indistinguishable. Nevertheless, an ICU radiograph of the chest is valuable, mainly in identifying such complications as malpositioned intravenous catheters, Swan-Ganz catheters, pacemakers, nasogastric tubes, endotracheal tubes, chest tubes, and mediastinal tubes, and ectopic gas related to mechanical ventilation. Understanding the limitations of the portable ICU chest film in the diagnosis of specific diseases and being alert to possible iatrogenic complications will increase the usefulness of ICU chest radiography.
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The radiographic examination of the chest plays an important role in the evaluation of patients in the intensive care unit. The maximum diagnostic value of the radiographs can be achieved only if the films are frequently reviewed, preferably in a daily working conference of the radiologist with the clinicians. Without detailed knowledge of the patient's clinical status, the radiologist will be severely limited in the precision with which the radiographs can be used to evaluate the status of a patient in the intensive care unit.
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After prolonged deliberations guide lines have now been agreed upon regarding the training and examination of nursing personnel for work in recovery and intensive care units. The recommendations, as adopted by the German Hospital Association 16th November 1976, cannot be accepted unreservedly. One of the main objections is that the proposed course of training would lead to excessive specialization at too early a stage. The aim should be to provide training of an interdisciplinary character, including anaesthesia.