Articles: critical-care.
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To evaluate the training of clinical staff in the use of interhospital transfer guidelines and to examine the underlying decision-making behavior in organizing patient transfers between hospitals. ⋯ Clinical staff can make informed and appropriate decisions by using standardized guidelines when organizing interhospital transfers.
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To analyze the status of the teaching of critical care at the postgraduate and undergraduate levels in Europe. ⋯ The standardization of curriculum content on critical care medicine, the clear definition of competence (the combination of knowledge, attitudes, skills, and judgment necessary to practice) in medical schools, and better coordinated postgraduate training are needed to clarify an educational approach in the field. Practitioners of critical care medicine will have to participate actively on curriculum committees. The recognition of critical care medicine as a specialty or subspecialty and as an academic discipline will facilitate the achievement of a comprehensive critical care education program.
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A fixed-wing aircraft (Beechcraft KingAir B200 C) fitted as an airborne intensive care facility is described. It completed 2000 missions from 1987-1992 for distances up to 1300 km. Features include: 1. ⋯ Provision of 24Ov AC (alternating current) and 28v DC (direct current) electrical energy. 8. Pressurization and climate control. 9. Satisfactory aviation performance for conditions encountered, with single-pilot operation.
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Critical care medicine · Mar 1996
Review Randomized Controlled Trial Clinical TrialTherapy of alcohol withdrawal syndrome in intensive care unit patients following trauma: results of a prospective, randomized trial.
To assess the effect of three different alcohol withdrawal therapy regimens in traumatized chronic alcoholic patients with respect to the duration of mechanical ventilation and the frequency of pneumonia and cardiac disorders during their intensive care unit (ICU) stay. ⋯ There was some advantage in the flunitrazepam/clonidine regimen with respect to pneumonia and the necessity for mechanical ventilation. However, four (7%) patients had to be excluded from the study due to ongoing hallucinations during therapy. Also, cardiac complications were increased in this group. Thus, flunitrazepam/haloperidol should be preferred in patients with cardiac or pulmonary risk. Further studies are required to determine which therapy should be considered.
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Minerva anestesiologica · Mar 1996
Review[Experience of an intermediate respiratory intensive therapy in the treatment of prolonged weaning from mechanical ventilation].
109 patients who suffered from an episode of acute respiratory failure, necessitated mechanical ventilation (MV) in a general Intensive Care Unit (ICU) and admitted to our Respiratory Intermediate Intensive Unit (RIIU), were retrospectively evaluated for outcome and weaning success. The patients, 69 +/- 9 years old, presented the following diseases: COLD (70%), cardiovascular (15%) and neuromuscular (15%). A relapse of underlying disease (62%), pneumonia (20%), thoraco-muscular pump failure (15%) and pulmonary embolism (3%) were the relapsing causes needing the ICU admission. ⋯ Maximal inspiratory pressure (31 +/- 7 cmH2O) and respiratory rate/tidal volume (83 +/- 34) were measured within 48 hours after RIIU admission. 82 subjects (75%) were weaned after 6 +/- 4 days of MV using in 87% of patients pressure support technique with spontaneous breathing cycles with oxygen supplementation. 8 patients on 109 (7%) died; 20 patients on 109 (18%) were discharged after 40 +/- 9 days of stay in RIIU necessitating home MV more than 18 hours/day by means of a tracheostomy. All patients stay in RIIU for 17 +/- 7 days with a mean cost per die of 750 thousands lire. Our data suggest that a RIIU institution for prolonged weaning in chronic diseases may be a useful solution to decrease superfluous stays in ICU decreasing costs without ba worsening in quality of care.