Articles: critical-care.
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Advances in the area of pediatric medicine during the past few years have presented ethical dilemmas for the physician to consider. This article discusses the ethical principles upon which clinical reasoning and judgments can be made.
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It is evident that the field of pediatric critical care is evolving rapidly, but the prime issue remains the proper delivery of scarce and expensive resources to the most patients. In order to do so it is necessary to determine where current resources exist. This has been difficult to accomplish accurately on a national basis, although it may be possible on a regional level. ⋯ Models of regionalization will provide the basic structure for the development of these systems. The Model for a Pediatric Critical Care System proposed by the California Critical Care Coalition and District IX of the American Academy of Pediatrics should be readily applicable to any region. It is hoped that the information and examples provided in this article will provide some guidelines for those interested in promoting regionalization of pediatric critical care across the nation.
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NAACOGS Clin Issu Perinat Womens Health Nurs · Jan 1992
Principles of intracranial pressure monitoring.
Increased intracranial pressure (ICP) is a life-threatening condition that requires immediate recognition and therapeutic intervention. The obstetric nurse must have in-depth knowledge of the physiologic changes occurring during pregnancy, the relationship between these changes and cerebrovascular accidents, and the pathophysiology of increased intracranial pressure to provide the most comprehensive nursing care. This chapter describes fundamental principles of intracranial pressure monitoring.
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Current methods of ventilation do not allow adequate ventilation of the affected lungs in the presence of unilateral disease, e.g., unilateral atelectasis, diaphragmatic hernia, or lobar emphysema. Using a bilumen endotracheal tube and two independent ventilators, synchronized simultaneous independent lung ventilation (SILV) can be achieved. This technique provides a method of treating unilobar, unilateral, or multifocal lung disease effectively. This article describes the author's methodology and clinical experience with SILV.
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Critical care clinics · Jan 1992
Historical ArticleThe historical evolution, current status, and prospective development of pediatric critical care.
This article describes the multiple historic origins of pediatric critical care medicine and the evolution of the subspecialty, from the late 1950s with the first units dedicated to the care of critically ill and injured infants and children, to the present status as a recognized medical subspecialty. Also discussed are current major issues and future challenges that flow from both this historic background and a commitment to critically ill children. Presented are specific considerations for physicians in this subspecialty to address as they plan for the future.