Articles: critical-care.
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As previously discussed, the majority of injury cases do not necessarily involve dramatic life-saving actions, but rather very rudimentary, promptly applied precautions. For most victims of trauma, therefore, we offer reassurance and simple compassion in their time of need. One of the more important lessons to be learned here is that, beyond prehospital injury "management" or "treatment," we should always remember to provide the best possible prehospital injury care. ⋯ Successful transport of disaster victims, whether in the prehospital phase or during interhospital transfer, requires careful attention to treatment priorities, such as simple measures for airway control and ventilation, and care to prevent further injuries by appropriate immobilization techniques. The use of fully equipped teams of multidisciplinary critical care specialists in mass disaster situations is in its infancy. It is clear that with properly adapted hardware and personnel trained to function in adverse environments while effectively delivering intensive care to a large number of patients with a variety of clinical syndromes, survival can be significantly increased for the most acutely ill.
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The experimental data supporting and opposing the use of intravenous albumin in various groups of patients are provided, and conclusions are drawn from these data. The metabolism and kinetics of albumin are reviewed, and the importance of albumin levels in critically ill patients is discussed. The reviewed literature supports the conclusion that in most critically ill patients, intravenous albumin does not improve outcome.
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The development and establishment of intensive care units for adult patients requires a far-reaching subdivision into surgical and conservatively oriented intensive care for qualitative and quantitative reasons. Insufficiently substantiated claims to monopolization of intensive care techniques that are polemically asserted have to be strongly contradicted. The present paper is concerned with approved structural concepts of intensive care developed by Deutsche Krankenhausgesellschaft and various medical societies. They are supplemented by personal experience in the field of internal intensive care.
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Crit Care Nurs Clin North Am · Mar 1991
Pain assessment. The problem of pain in the critically ill patient.
In the face of maintaining airways and providing circulatory support, pain assessment may be given a low priority in the critical care unit. On the contrary, given the deleterious effects pain may have for the critically ill or injured patient, pain assessment must be given a high priority to develop effective management plans. In addition to assessing the patient's pain, critical care nurses must be acutely aware of their own personal biases and how those biases might influence perceptions of the patient's suffering.