P.30 Obstetric admissions to the intensive care unit: Focus on major haemorrhage and role of the high dependency unit

2021 ◽  
Vol 46 ◽  
pp. 103028
Author(s):  
L. Al-Ani ◽  
M.A. Broom
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Major Haemorrhage ◽  
High Dependency Unit ◽  
High Dependency

scholarly journals Prevention of Nosocomial Infection & role of Hand Hygiene Compliance in a Private Hospital of Bangladesh

2017 ◽  
Vol 5 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Afsana Begum ◽  
Md Shafiqul Bari ◽  
Md Abul Kalam Azad ◽  
Md Iqbal Hossain ◽  
Pradip Ranjan Saha
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Nosocomial Infection ◽  
Hand Hygiene Compliance ◽  
High Dependency Unit ◽  
High Dependency ◽  
Hygiene Compliance

Background: Nosocomial infection (NI) is a major cause of morbidity and mortality of patients attending the healthcare facilities all over the world. Only a few studies regarding this issue have been conducted in Bangladesh.Objective: To describe the load of NI and to assess role of hand hygiene compliance of doctors and nurses regarding its prevention.Method: In this cross-sectional study, medical records of all patients admitted from January 2014 to June 2014 were reviewed and data were collected from patients who had diagnosis of NI. Collected data includes month wise number of NI patients, types of NI, organism responsible for NI and hand hygiene compliance of doctors and nurses. Regarding hand hygiene compliance only critical care areas were considered.Results: During the study period, a total of 8769 patients were admitted in all inpatient departments and critical care areas (cardiac intensive care unit, neonatal intensive care unit, general intensive care unit, coronary care unit, general high dependency unit and cardiac high dependency unit) of the hospital and number of NI was 201 (2.29%). The highest NI was respiratory tract infection (63%) and the lowest was skin & soft tissue infection (2%). Predominant organisms responsible were E. coli (16%), acinetobacter species (15%), Pseudomonas species (14%), Klebsiella species (13%), Serratia species (13%) and Candida species (13%). The highest average hand hygiene compliance (67.67%) and lowest NI (1.14%) was observed in June 2014.Conclusion: In this study, NI rate was the lowest when the hand hygiene compliance was the highest. So, it is obvious that implementation of hand hygiene may be one of the important measures to prevent NI. So, hospitals should have strict guidelines and review measures to prevent this man made phenomenon. All these efforts will not only reduce patient morbidity, but will also reduce the use of antibiotics and healthcare costs of the country.Bangladesh Crit Care J September 2017; 5(2): 83-87

Primary Casualty Reception Ship: the hospital within—Operation Granby

1992 ◽  
Vol 78 (2) ◽  
pp. 55-64
Author(s):  
E. P. Dewa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Support Services ◽  
Persian Gulf ◽  
Medical Team ◽  
High Dependency Unit ◽  
Full Support ◽  
Hospital Facility ◽  
High Dependency

SummaryAs the build-up of Operation Granby forces developed in the Gulf, casualty estimates indicated the need for a 100-bed hospital facility to care for the possible maritime casualties. RF A Argus, the Air Training Ship, was identified as the potential Primary Casualty Reception Ship (PCRS) and at the end of September 1990 plans were drawn up to convert the forward hangar into a two-storey 100-bed hospital in collective protection (COLPRO).In the three weeks prior to deployment, the hospital was designed, built, equipped and staffed.Argus arrived in the Gulf in mid-November as the PCRS with, all in COLPRO, a 10-bed intensive care unit (ICU), a 14-bed high dependency unit (HDU), a 76-bed low dependency unit (LDU) plus four operating tables in two theatres with full support services.The hospital was staffed by a medical team of 136 personnel and supported by the Air department with four casualty evacuation helicopters, an RN Party and the staff of the RFA.One hundred and five patients were treated of which 78 were returned to duty. Argus as PCRS spent longer in the northern Persian Gulf than any other ship, UK or US.

Care of the Neurosurgical Patient in the Post Anesthetic Care Unit

2001 ◽  
Vol 2 (3-4) ◽  
pp. 14-21
Author(s):  
Melissa McNeillis
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
High Dependency Unit ◽  
Anesthetic Care ◽  
Anaesthetic Care ◽  
High Dependency ◽  
Neurosurgical Patient ◽  
Initial Care ◽  
Care Study

In this care study I will explain the care that SVB received following his admission to the Post Anaesthetic Care unit (PACU) and summarise his discharge to the Intensive Care Unit (ICU). The limitations that this case report presents are that often the care received in the PACU can be quite short in terms of total length of stay in hospital. It is not uncommon that High Dependency patients are received for initial care into the PACU following surgery and to be further discharged and nursed in either a dedicated High Dependency Unit or to the Intensive Care Unit.

Postoperative care

2019 ◽  
pp. 141-150
Author(s):  
Nuria Masip
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Paediatric Intensive Care Unit ◽  
Postoperative Nausea And Vomiting ◽  
Level Of Care ◽  
High Dependency Unit ◽  
Anaesthetic Care ◽  
High Dependency ◽  
Postoperative Problems

After surgery, and before being transferred to the ward, patients will be recovered in a specially designated area: the recovery area or post-anaesthetic care unit (PACU). In recovery, there are some postoperative problems that we need to be familiar with managing: postoperative nausea and vomiting (PONV), emergence delirium (it is important to recognize it, and be able to differentiate it from agitation) and pain. Those patients who need postoperative critical care will be admitted to a high-dependency unit (HDU) or paediatric intensive care unit (PICU), depending on their required level of care. Each time the patient is transferred to a different area, a thorough handover between the giving and receiving team is paramount. This chapter provides the reader with the means to manage common recovery problems, and an understanding of patient postoperative dependency levels.

scholarly journals Severe Maternal Morbidity: Admission Shift From Intensive Care Unit to Obstetric High-dependency Unit

2021 ◽  
Author(s):  
Ning Gu ◽  
Yaning Zheng ◽  
Yimin Dai
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Apache Ii Score ◽  
High Dependency Unit ◽  
Chi Square ◽  
Icu Admission ◽  
Hypertensive Disorders ◽  
High Dependency ◽  
Obstetric Population ◽  
Length Of Icu Stay

Abstract Background: To study temporal trends of intensive care unit (ICU) admission in obstetric population after the introduction of obstetric high-dependency unit (HDU).Methods: This is a retrospective study of consecutive obstetric patients admitted to the ICU/HDU in a provincial referral center in China from January 2014 to December 2019. The collected information included maternal demographic characteristics, indications for ICU and HDU admission, the length of ICU stay, the total length of in-hospital stay and APACHE II score. Chi-square and ANOVA tests were used to determine statistical significance. The temporal changes were assessed with chi-square test for linear trend.Results: A total of 40 412 women delivered and 447 (11.1‰) women were admitted to ICU in this 6-year period. The rate of ICU admission peaked at 15.9‰ in 2016 and then dropped to 6.7‰ in 2019 with the introduction of obstetric HDU. The average APACHE II score increased significantly from 6.8 to 12.3 (P<0.001) and the average length of ICU stay increased from 1.7 to 7.1 days (P<0.001). The main indications for maternal ICU admissions were hypertensive disorders in pregnancy (39.8%), cardiac disease (24.8%), and other medical disorders (21.5%); while the most common reasons for referring to HDU were hypertensive disorders of pregnancy (46.5%) and obstetric hemorrhage (43.0%). After adjusting for the proportion of high-risk pregnancies, the establishment of HDU reduced 20% of ICU admission (aOR = 0.804, 95% CI =0.666-0.972).Conclusions: The introduction of HDU helps to reduce ICU utilization in obstetric population.

scholarly journals Plasma-Calprotectin as an Indicator for Immediate Need of Intensive Care Treatment in Suspected Sepsis

2021 ◽  
Author(s):  
Asa Emilia Parke ◽  
Christian Unge ◽  
David Yu ◽  
Jonas Sunden-Cullberg ◽  
Kristoffer Stralin
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Intensive Care Treatment ◽  
High Dependency Unit ◽  
Suspected Sepsis ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
Promising Tool ◽  
High Dependency

Abstract Introduction: Decisions regarding need of transfer to intensive care of patients with sepsis in the emergency department is challenging. We hypothesised that the new biomarker plasma-calprotectin could be used to help select patients who need intensive care, since it already has shown to be a promising tool in the intensive care unit. Methods: This prospective study was performed on consecutive sepsis alert patients. The alert summons a multidisciplinary team of physicians from the emergency department, the Department of Infectious Diseases, and the intensive care unit, who evaluate patients for possible infection and decide where to transfer the patient. Blood sampling was performed on consecutive sepsis alert patients. C-reactive protein, procalcitonin, neutrophils, and lymphocytes were routinely analysed, p-calprotectin was analysed from frozen plasma samples using a specific turbidimetric assay. Results: Among 367 sepsis alert patients, 335 had an infection of whom 66 were immediately transferred to the intensive care unit or high dependency unit. 269 patients were transferred to ordinary wards. Median p-calprotectin for all infected patients was 2.2 (IQR 1.2–3.9), 3.3 (IQR 1.6–5.2) among those transferred immediately to intensive care unit/ high dependency unit and 2.1 (IQR 1.1–3.5) among those transferred to wards (p = 0.0001). Analysis of area under the receiver-operating characteristic (ROC) curve for transferral to higher care level showed superiority for p-calprotectin compared to procalcitonin and neutrophil-lymphocyte-ratio, both regarding all sepsis alert cases and regarding the patients with infection (p < 0.001 for all comparisons)). The best p-calprotectin cut-off 4.0 mg/L showed sensitivity 42.5% and specificity 83% for transferral to ICU/HDU among patients with infection. Conclusion: In sepsis alert patients, p-calprotectin was significantly elevated in patients transferred immediately to intensive care. P-calprotectin was superior to traditional biomarkers as a predictor of need for intensive care. Trial registration: Not registered, as the sepsis alert was developed as a clinical supportive tool.

scholarly journals Why Obstetric Patients are admitted to Intensive Care Unit? A Retrospective Study

2012 ◽  
Vol 4 (2) ◽  
pp. 90-92
Author(s):  
Sunita Ghike ◽  
Prashant Asegaonkar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Maternal Mortality ◽  
South Asian ◽  
Medical Illness ◽  
High Dependency Unit ◽  
Icu Admission ◽  
High Dependency ◽  
Number Of Patients

ABSTRACT Pregnant women are often young and in their reproductive years. In majority of them, pregnancy and labor usually progresses uneventfully. Sudden complications occurring during this period may lead to maternal mortality. Though obstetric admission forms a small proportion of ICU admission, mortality among them is high. Proper antenatal care is still the mainstay of preventing complications in pregnant woman. This study was conducted to evaluate the obstetric admission to intensive care unit and causes and outcome of them. Two years retrospective review of all the obstetric admissions (Antenatal and postnatal up to 6 weeks post delivery) were done. Total number of patients admitted to ICU in this period, total number of deliveries in study period and total obstetric patients admitted to ICU were noted. The data included demographic details, obstetric history, indications for ICU admission, pre-existing medical illness and pregnancy complications necessitating ICU admissions. Total obstetric patients admitted to ICU were 1.04% of all deliveries. 48.53% women had pre-existing medical illness. 87.24% were antenatal and 12.67% were postnatal patients. 70.21% women had obstetric/medical illnesses during pregnancy which ICU admissions. Maternal mortality was observed in 31.91%. There was.changing trend in causes of maternal mortality, i.e. tropical diseases like dengue and malaria are found to be the cause of mortality in developing countries like India. Thus, there is need of obstetric high dependency unit (OHDU) at every center. How to cite this article Ghike S, Asegaonkar P. Why Obstetric Patients are admitted to Intensive Care Unit? A Retrospective Study. J South Asian Feder Obst Gynae 2012;4(2):90-92.

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