Articles: critical-illness.
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AJR Am J Roentgenol · Oct 1992
Diagnostic and therapeutic use of chest sonography: value in critically ill patients.
Portable chest radiography, used for critically ill patients, often fails to depict thoracic disease clearly. Chest sonography allows good characterization of pleural diseases, mediastinal lesions, and pulmonary consolidations, and provides accurate and safe guidance for interventional procedures. Accordingly, we evaluated its usefulness in the diagnosis and management of critically ill patients. ⋯ Chest sonography is a useful diagnostic tool for critically ill patients with chest diseases. This technique can be particularly helpful when CT is not available or when critically ill patients cannot be moved.
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We prospectively studied transport of a group of 100 surgery/trauma patients and a matched control group in the ICU. APACHE II scores for the two groups were 23 +/- 6 and 20 +/- 8. During transport both groups had ECG, heart rate, blood pressure, and oxygen saturation continuously monitored. ⋯ Abdominal CT scanning and angiography were associated with the highest percentage of tests leading to a management change (51% and 57%). The average charge to the patient was $612.00 and the average cost to the hospital $452.00. Our results suggest that while physiologic changes are frequent during transport, they are also frequent in ICU patients as a consequence of the severity of illness.(ABSTRACT TRUNCATED AT 250 WORDS)
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Critically ill patients are transported within and between hospitals on a regular basis; thus, transport of the critically ill is a component of most intensivists-practice. The motivation for these transports lies in obtaining diagnostic or therapeutic services not available at the bedside (intrahospital transport) or not available in the sending institution (interhospital transport). Deterioration in respiratory, cardiovascular, and other physiological systems is a potential complication of any patient transport. Using appropriate equipment and personnel and planning for each transport can minimize these complications and ensure optimal benefit to the patient.
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To examine the decision-making process to withhold or stop life support. ⋯ Decision making to withhold or withdraw life-support therapy from critically ill persons involves complex, difficult processes. Successful management of the tension among life extension, quality of life, patient autonomy, and social justice requires better understanding of these processes.