Articles: critical-care.
-
Critical care medicine · Jun 1993
Practice Guideline GuidelineGuidelines for the transfer of critically ill patients. Guidelines Committee of the American College of Critical Care Medicine; Society of Critical Care Medicine and American Association of Critical-Care Nurses Transfer Guidelines Task Force.
The development of practice guidelines for the conduct of intra- and interhospital transport of the critically ill patient. ⋯ The available data have allowed us to develop an evidence-based practice policy for the intra- and interhospital transport of the critically ill.
-
Since the development of surgical critical care (SCC) as a discrete body of knowledge and its recognition by the American Board of Surgery (ABS), it has been beset by several controversies. One controversy is that the Residency Review Committee (RRC) for Surgery mandated that approved SCC training be 1 year long with no operative experience. A survey was conducted to determine the opinions and experiences on this controversy and others of 498 surgeons who regularly practice SCC. ⋯ Two thirds disagreed with the RRC's ban on operative experience during SCC fellowships and 71% believed that this prohibition limited the pool of surgical applicants to SCC programs. There were no significant differences in the responses between any of the major subgroups. Interestingly, 50% of the respondents who had completed RRC-approved SCC fellowships stated that their fellowship included operative experience.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Intensive care patients often require inotropic support to stabilise circulation and to optimise oxygen supply. In this context, the catecholamines norepinephrine (noradrenaline), epinephrine (adrenaline), dopamine and dobutamine are still the mainstay of therapy. They provide, to different extents, a variety of adrenoceptor-mediated actions comprising vasoconstriction (via alpha-receptors) as well as vasodilatation (via beta 1-receptors), and an increase in cardiac output by enhancing inotropy and heart rate (again via beta 1-receptors). ⋯ Depending on the dosage and the speed of intravenous administration, the use of phosphodiesterase inhibitors sometimes results in pronounced decrease of blood pressure which may require vasopressor therapy. Other drugs including histamine H2-agonists are currently under investigation. Their value in the treatment of intensive care patients has still to be evaluated.
-
Practice Guideline Guideline
Guidelines for the transfer of critically ill patients. Guidelines Committee, American College of Critical Care Medicine, Society of Critical Care Medicine and the Transfer Guidelines Task Force.
The development of practice guidelines for the conduct of intra- and interhospital transport of the critically ill patient. ⋯ The available data has allowed the authors to develop an evidence-based practice policy for the intra- and interhospital transport of the critically ill.