Articles: critical-care.
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Journal of critical care · Jun 1997
Editorial CommentThe way to a man's heart is through his stomach.
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Multicenter Study
Physicians' survival predictions for patients with acute congestive heart failure.
Current guidelines suggest that patients with low likelihoods of survival may be excluded from intensive care. Patients with new or exacerbated congestive heart failure are frequently but not inevitably admitted to critical care units. ⋯ Physicians have great difficulty predicting survival for patients with acute congestive heart failure and cannot identify patients with poor chances of survival. Current triage guidelines that suggest patients with poor chances of survival may be excluded from critical care may be impractical or harmful.
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This article, the second in a two-part series, outlines the role of the nurse in assessing and implementing aspects of care of the mechanically ventilated patient in the intensive care unit, including sedation, communication, safety, nutrition, and the needs of patients' visitors. The ultimate goal (Where possible) is to help the patient manage without the ventilator. This process is referred to as 'weaning' and often involves the nurse participating in intricate patient assessment and the implementation of specialized care. The need for a multidisciplinary approach to patient care is emphasized.
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Hospital mortality and length of stay, both adjusted for severity of illness, have been used as indicators of effectiveness and efficiency of health care in critical patients. ⋯ Clinical and economical performance of hospitals can be quantified with simple indicators which allow to compare centers. Hospitals can be effective and efficient at the same time.