Articles: critical-care.
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Care of the critically ill has become increasingly challenging due to demands from external sources to measure the quality and appropriateness of care provided. Quality assurance is the responsibility of every critical care nurse and requires vigilance as well as a knowledge of the principles of standards, monitoring and evaluation. Through quality assurance activities, the contribution of critical care nurses in the achievement of patient outcomes can be measured. Quality assurance challenges us to evaluate the way we practice, and assists us to continuously improve the way we provide care to critically ill patients.
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Review Guideline
Pediatric interhospital critical care transport: consensus of a national leadership conference.
As pediatric interhospital critical care transport has evolved toward a distinct discipline, practitioners in this field have recognized the need for guidelines for transport program development and patient care. At a gathering of medical directors of pediatric transport programs, the following topics were discussed: team composition and transport staffing, training requirements for pediatric and nonpediatric transport teams, goals and design of a transport data base, and medical-legal issues, including the responsibilities of the referring and receiving institutions. Consensus recommendations were made for the major issues in each of these areas. Several questions were raised which may be answered by multiinstitutional studies.
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I have reviewed the identifiable hemodynamic effects of selected inotropic and vasoactive agents in the context of several clinical patient subsets. Knowledge of relative hemodynamic effects of various agents permits the selection of those that are best in specific clinical circumstances. Combining drugs may only occasionally be advisable to supplement a desired effect or to attenuate an unwanted one.