Articles: critical-care.
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Today patients that are otherwise stable may require mechanical ventilation for prolonged periods of time. The medical-surgical nurse may be expected to care for these patients in a setting outside the intensive care unit. Basic knowledge of the modes of ventilation, assessment, and troubleshooting of ventilators and assessment and care of the patient requiring mechanical ventilation are reviewed in this article.
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Critical care clinics · Apr 1997
ReviewCritical care in East Asia. Little dragons and sleeping giants.
Southeast Asia is the world's region of most rapid economic growth. The countries in the region vary widely in annual per capita income and health expenditure. ⋯ Most countries now have a Society of Intensive or Critical Care Medicine. Specialist training and examination systems for Intensive Care are established in Hong Kong, Taiwan, and the Philippines.
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The field of application for fibreoptic bronchoscopy (FB) in the intensive care unit has been extended since the generalised introduction of fibroscopes of 4.9 mm in diameter (previously called paediatric fibroscopes). Paediatric and neonatal intensive care units have benefited from the availability in the market of these small endoscopes for 3.5 and 2.2 mm. The protected brush and alveolar lavage (LBA) enables a specific diagnosis to be made in bacterial pneumonia acquired during ventilation. ⋯ In the case of respiratory burns, tracheobronchial fracture and post intubation stenosis, FB enables both the diagnosis to be established and the level at which the lesion occurs. In paediatric intensive care, a fibroscope of 3.5 mm is used for performing LBA (opportunistic pneumonias), difficult intubation (facial dysmorphia), endoscopic diagnoses, in particular where there is a suspicion of an endobronchial foreign body, the assessment of unexplained dyspnoea (tracheal stenosis by vascular ring) and obstructive lesions. In neonatal intensive care, a fibroscope of 2.2 mm is used for difficult intubation and the localisation of lesions induced by ventilation.
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Critical care clinics · Apr 1997
ReviewCritical care in Africa. North to south and the future with special reference to southern Africa.
The medical fraternity in Africa needs to ration resource allocation and aptly apply distributive justice. At present, pockets of Intensive Care Units are held together largely by individuals. Unless the correct assistance and support is provided to develop its vast potential, African Intensive Care will degenerate into primary health care.