Updated hospital associated venous thromboembolism outcomes with 90-days follow-up after hospitalisation for severe COVID-19 in two UK critical care units

Sudden speechlessness (SS) is commonly experienced by patients admitted to critical care units. Although literature findings document challenges associated with periods of SS, the prevalence is unknown. The purpose of this study is to determine the prevalence and characteristics of adult SS patients in four critical care units at a university-affiliated tertiary care hospital. Data are collected on 9 randomly selected days over a 4-month period. The daily prevalence of SS ranges from 16% to 24% in each unit. Characteristic data collected includes patient age, gender, medical diagnosis related to SS episode, type of speechlessness, days since SS began, and communication strategies in use. Respiratory intubation related to various clinical diagnoses is the main cause for SS. Use of multiple specific strategies to convey needs during SS periods are identified. Follow-up studies to further define the prevalence of SS in settings beyond the critical care environment are recommended.

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Prototipo para la comparación de patrones temporales secuenciales de arritmias cardíacas [Prototype for comparison of sequential temporal patterns of cardiac arrhythmias]

Ventana informatica ◽

10.30554/ventanainform.26.134.2012 ◽

2012 ◽

Author(s):

Alejandro Javier Hadad ◽

Agustín Benjamín Ezequiel Solano ◽

Bartolomé Drozdowicz

Keyword(s):

Critical Care ◽

Cardiac Arrhythmias ◽

Temporal Patterns ◽

Clinical Settings ◽

Analysis Model ◽

Reference Case ◽

Software Application ◽

Critical Care Units ◽

Additional Information

Resumen En el presente trabajo se presenta un prototipo para la búsqueda de patrones temporales secuenciales de arritmias cardíacas. Dicha búsqueda está orientada al soporte de tareas de monitoreo en ámbitos clínicos a través de modelos de seguimiento temporal en unidades de cuidados críticos. En el proceso de diseño se abordaron diferentes dimensiones de análisis desde el punto de vista de la abstracción temporal. Para el desarrollo de los modelos de seguimiento se eligió como caso de referencia el monitoreo de las arritmias. Para el análisis de secuencias se construyó un modelo basado en el algoritmo de Smith-Waterman. El seguimiento con este modelo generó información adicional, potencialmente utilizable en el pronóstico de evolución en cuidados críticos. Con estas especificaciones se desarrolló una aplicación de software que tiene como objetivo principal comparar y ponderar registros de electrocardiograma (ECG), clasificados según diferentes tipos de latidos. La aplicación funciona como soporte para la exploración y el análisis con fines diagnósticos de afecciones evidenciadas a partir de arritmias cardíacas, brindando indicios acerca de la evolución temporal entre registros similares. Palabras ClavesPrototipo, Supervisión, Arritmias, Patrones temporales Abstract This paper presents a prototype for the sequential search for temporal patterns of cardiac arrhythmias. This search is aimed at supporting monitoring tasks in clinical settings through time tracking models in critical care units. In the design process are addressed different dimensions of analysis from the viewpoint of abstraction in time. For the development of monitoring models was taken as the reference case monitoring of arrhythmias. The sequence analysis model was constructed based on the Smith-Waterman algorithm. Follow-up with this model generated information, potentially useful in forecasting trends in critical care. With these specifications the software application was developed to compare and weight electrocardiogram records. The application work like a support to exploration and analysis diagnostic tasks over illness related to cardiac arrhythmias and generate additional information about the evolution based on historical with similar sequential temporal patterns. Keywords Prototype, Supervision, Arrhythmias, Temporal patterns

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Implementing target range oxygen in critical care: A quality improvement pilot study

Journal of the Intensive Care Society ◽

10.1177/1751143719892784 ◽

2019 ◽

pp. 175114371989278

Author(s):

Rosie Heartshorne ◽

Jenna Cardell ◽

Ronan O'Driscoll ◽

Tim Fudge ◽

Paul Dark

Keyword(s):

Critical Care ◽

Quality Improvement ◽

Pilot Study ◽

Care Staff ◽

Target Range ◽

Baseline Survey ◽

Staff Attitudes ◽

Critical Care Units ◽

Staff Members

Background Iatrogenic hyperoxaemia is common on critical care units and has been associated with increased mortality. We commenced a quality improvement pilot study to analyse the views and practice of critical care staff regarding oxygen therapy and to change practice to ensure that all patients have a prescribed target oxygen saturation range. Methods A baseline measurement of oxygen target range prescribing was undertaken alongside a survey of staff attitudes. We then commenced a programme of change, widely promoting an agreed oxygen target range prescribing policy. The analyses of target range prescribing and staff survey were repeated four to five months later. Results Thirty-three staff members completed the baseline survey, compared to 29 in the follow-up survey. There was no discernible change in staff attitudes towards oxygen target range prescribing. Fifty-four patients were included in the baseline survey and 124 patients were assessed post implementation of changes. The proportion of patients with an oxygen prescription with a target range improved from 85% to 95% (χ2 = 5.17, p = 0.02) and the proportion of patients with an appropriate prescribed target saturation range increased from 85% to 91% (χ2 = 1.4, p = 0.24). The improvement in target range prescribing was maintained at 96% 12 months later. Conclusions The introduction and promotion of a structured protocol for oxygen prescribing were associated with a sustained increase in the proportion of patients with a prescribed oxygen target range on this unit.

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Infusion medication concentrations in UK’s critical care areas: Are the Intensive Care Society’s recommendations being used?

Journal of the Intensive Care Society ◽

10.1177/1751143716662664 ◽

2016 ◽

Vol 18 (1) ◽

pp. 30-35 ◽

Cited By ~ 2

Author(s):

Yovita D Titiesari ◽

Greg Barton ◽

Mark Borthwick ◽

Susan Keeling ◽

Peter Keeling

Keyword(s):

Critical Care ◽

Patient Safety ◽

Intensive Care ◽

Intensive Care Society ◽

Care Society ◽

Critical Care Units ◽

The Uk

Following two studies done in 2007 and 2009, a follow-up of the adherence to the suggested guidelines on drug standardisation has been performed with a suggestion for future standards that can be achieved, to complement the recently published Carter report. The Intensive Care Society (ICS) introduced recommendations for infusion concentrations of 16 medications commonly used in critical care areas. The importance being improvement in patient safety and rationalised use of available critical care resources. Five years after publication of these recommendations, a further audit has been undertaken to assess the level of acceptance and application. This revealed that 89.5% of the 133 surveyed units (representing 42.49% critical care units across the UK) have adopted the recommendations. There are further medication concentrations which could also be standardised.

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Venous thromboembolism prophylaxis usage in critical care units in National Hospital Sri Lanka

Sri Lankan Journal of Anaesthesiology ◽

10.4038/slja.v20i1.4273 ◽

2012 ◽

Vol 20 (1) ◽

pp. 33

Author(s):

IACL Perera

Keyword(s):

Critical Care ◽

Venous Thromboembolism ◽

Sri Lanka ◽

National Hospital ◽

Thromboembolism Prophylaxis ◽

Critical Care Units ◽

Venous Thromboembolism Prophylaxis

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Post Discharge Clinically Overt Venous Thromboembolism in Orthopaedic Surgery Patients with Negative Venography -an Overview Analysis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650681 ◽

1996 ◽

Vol 76 (06) ◽

pp. 0887-0892 ◽

Cited By ~ 32

Author(s):

Serena Ricotta ◽

Alfonso lorio ◽

Pasquale Parise ◽

Giuseppe G Nenci ◽

Giancarlo Agnelli

Keyword(s):

Venous Thromboembolism ◽

Orthopaedic Surgery ◽

Diagnostic Methods ◽

Future Research ◽

Post Discharge ◽

Pharmacological Prophylaxis ◽

Vein Thrombosis ◽

Overview Analysis ◽

Major Orthopaedic Surgery

SummaryA high incidence of post-discharge venous thromboembolism in orthopaedic surgery patients has been recently reported drawing further attention to the unresolved issue of the optimal duration of the pharmacological prophylaxis. We performed an overview analysis in order to evaluate the incidence of late occurring clinically overt venous thromboembolism in major orthopaedic surgery patients discharged from the hospital with a negative venography and without further pharmacological prophylaxis. We selected the studies published from January 1974 to December 1995 on the prophylaxis of venous thromboembolism after major orthopaedic surgery fulfilling the following criteria: 1) adoption of pharmacological prophylaxis, 2) performing of a bilateral venography before discharge, 3) interruption of pharmacological prophylaxis at discharge in patients with negative venography, and 4) post-discharge follow-up of the patients for at least four weeks. Out of 31 identified studies, 13 fulfilled the overview criteria. The total number of evaluated patients was 4120. An adequate venography was obtained in 3469 patients (84.1%). In the 2361 patients with negative venography (68.1%), 30 episodes of symptomatic venous thromboembolism after hospital discharge were reported with a resulting cumulative incidence of 1.27% (95% C.I. 0.82-1.72) and a weighted mean incidence of 1.52% (95% C.I. 1.05-1.95). Six cases of pulmonary embolism were reported. Our overview showed a low incidence of clinically overt venous thromboembolism at follow-up in major orthopaedic surgery patients discharged with negative venography. Extending pharmacological prophylaxis in these patients does not appear to be justified. Venous thrombi leading to hospital re-admission are likely to be present but asymptomatic at the time of discharge. Future research should be directed toward improving the accuracy of non invasive diagnostic methods in order to replace venography in the screening of asymptomatic post-operative deep vein thrombosis.

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