Articles: critical-care.
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The critically ill patient is at high risk for developing complications and, consequently, higher costs of treatment. Because of the high costs associated with these patients, healthcare payers are demanding the development of criteria to ensure cost-effective care. Pharmacists can play an important role in ensuring cost-effective and appropriate care of critically ill patients. ⋯ Pharmacists can use newer tools such as cost-effective analysis and clinical decision analysis to identify and utilize drug therapies that result in decreased complications and decreased length of hospital stay, as measured by decreased costs. Equally important is the development of criteria for the appropriate use of drug therapies. Pharmacists must take an active role in working with physicians, nurses, payers, and risk managers.
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Inhalation injuries comprise three distinct clinical entities that may be classified according to the time of onset of symptoms, etiologic agents, and the anatomic location of injury. These entities are carbon monoxide toxicity, upper airway obstruction, and smoke inhalation or chemical injury. ⋯ Early aggressive treatment, including maintaining a patent airway, administering humidified oxygen and bronchodilators, and providing pulmonary toilet, is necessary to ensure the best possible outcome. Understanding the pathophysiology, clinical manifestations, diagnosis, medical management, and nursing implications of inhalation injuries can improve patient survival.