Articles: critical-care.
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Vet. Clin. North Am. Small Anim. Pract. · Nov 1995
ReviewTransfusion therapy in emergency and critical care medicine.
The administration of blood or its components can provide the life-saving element for a critically ill small animal patient. Shock from acute massive hemorrhage produces catastrophic cardiovascular changes requiring rapid, accurate resuscitation techniques for survival. Bleeding that occurs more slowly allows for the opportunity to discover and treat the inciting cause and to administer specific blood component.
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Pain assessment and management are recognized as major problems in critical care settings. However, little is known about pain management practices related to medical procedures performed in the ICU, particularly removal of chest tubes. ⋯ Practices associated with chest tube removal, especially pharmacologic management of procedure-related pain, vary in critical care units. Caregivers are advised to develop practice policies to guide decisions about management of acute pain in this patient population.
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The study objective was to determine the applicability of the acute physiology and chronic health evaluation (APACHE) II score in surgical patients with acute renal failure (ARF) requiring dialytic support, and to assess its utility in evaluating data from this specific disease group. This was a retrospective, partly prospective follow-up study of patients who developed ARF during their course of stay on the surgical intensive care unit (ICU) of a Dutch university hospital from January 1, 1986, to January 31, 1994. A total of 111 patients were identified, of whom 104 patients were considered eligible for this study. ⋯ APACHE II, when used at the time of initiation of dialytic support, proved to be a valid way in our surgical ICU to stratify ARF patients by the severity of their illness. Moreover, use of the AP2/AP1 ratio further improved the usefulness of this severity index and may help to identify patients who have little chance of survival. Predicting death with the APACHE II equation did not improve predictive power.
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Critical care medicine · Nov 1995
GuidelineGuidelines for resident physician training in critical care medicine. Guidelines/Practice Parameters Committee, American College of Critical Care Medicine of the Society of Critical Care Medicine.
To define a curriculum that outlines the core knowledge residents should possess upon completion of graduate training in order to be able to formulate and initiate a treatment plan for the critically ill patient. ⋯ A curriculum was developed that defines the core cognitive and procedural skills and special certifications residents should possess upon completion of residency training in order to be able to formulate and initiate a treatment plan for the critically ill patient. Special skills uniquely required for pediatric and adult patient populations are delineated.