The critically ill patient

2016 ◽  
Author(s):  
Jerry Nolan
Keyword(s):  
Critically Ill ◽  
Head Injuries ◽  
Anaesthetic Management ◽  
Pelvic Fractures ◽  
Critically Ill Patient ◽  
Abdominal Injuries ◽  
Chest Injuries ◽  
Life Threatening Illness ◽  
Limb Injuries ◽  
Life Threatening

This chapter discusses the anaesthetic management of the critically ill patient suffering from trauma or life-threatening illness. It begins by describing the principles of immediate trauma care, and the primary and secondary surveys. It then goes into more detail about head injuries, chest injuries, abdominal injuries, pelvic fractures, spinal injuries, limb injuries, burns, multiple trauma, post-cardiac arrest resuscitation care, and septic shock. It concludes by describing the transfer of the critically ill patient to the operating theatre or to another unit.

The critically ill patient

2018 ◽  
Author(s):  
Jerry Nolan
Keyword(s):  
Critically Ill ◽  
Head Injuries ◽  
Anaesthetic Management ◽  
Pelvic Fractures ◽  
Critically Ill Patient ◽  
Abdominal Injuries ◽  
Chest Injuries ◽  
Life Threatening Illness ◽  
Limb Injuries ◽  
Life Threatening

This chapter discusses the anaesthetic management of the critically ill patient suffering from trauma or life-threatening illness. It begins by describing the principles of immediate trauma care, and the primary and secondary surveys. It then goes into more detail about head injuries, chest injuries, abdominal injuries, pelvic fractures, spinal injuries, limb injuries, burns, multiple trauma, post-cardiac arrest resuscitation care, and septic shock. It concludes by describing the transfer of the critically ill patient to the operating theatre or to another unit.

Oxygen transport in the blood

1991 ◽  
Vol 11 (9) ◽  
pp. 20-33 ◽  
Author(s):  
KD Carpenter
Keyword(s):  
Critically Ill ◽  
Oxygen Transport ◽  
Oxygen Delivery ◽  
Critically Ill Patient ◽  
Dissociation Curve ◽  
Nursing Management ◽  
Oxyhemoglobin Dissociation Curve ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Oxyhemoglobin Dissociation

Knowledge of how oxygen is dissolved in the blood, transmitted through the bloodstream, and factors that affect oxygen delivery to body cells, is essential to the nursing management of the critically ill patient whose inherent physiologic mechanisms have been compromised by life-threatening illness. This article begins with a simplified review of respiration, progresses through a discussion of oxygen tension in the blood and hemoglobin transport of oxygen, and ends with a discussion of factors that affect the oxyhemoglobin dissociation curve.

Traffic Fatalities in Lusaka, Zambia

1979 ◽  
Vol 19 (1) ◽  
pp. 61-65 ◽  
Author(s):  
N. S. Patel
Keyword(s):  
Teaching Hospital ◽  
Forensic Medicine ◽  
Head Injuries ◽  
The Other ◽  
University Teaching ◽  
Steering Wheel ◽  
Traffic Fatalities ◽  
Abdominal Injuries ◽  
Chest Injuries ◽  
Two Wheeler

From January 1, 1974 to December 31, 1976 a total of 1746 a total of 1746 medicolegal post-mortems were done by the Department of Forensic Medicine, University Teaching Hospital, Lusaka. Out of these 630 (36 per cent) were traffic fatalities—516 (82 per cent) were males and 114 (18 per cent) were females. More than half of the victims—375 (59·5 per cent)—were between 21 and 40 years of age; 292 (46 per cent) were pedestrians; 121 (19 per cent) were drivers; 173 (27 per cent) were passengers; and 44 (7 per cent) were on two wheelers. 201 (40 per cent) accidents occurred between 18.00–24.00 hours; 131 (21 per cent) occurred between 12.00–18.00 hours. 418 (65 per cent) victims died on the spot, 18 (3 per cent) died on the way to the hospital and 127 (20 per cent) died within 24 hours of the accident. 407 (65 per cent) had chest injuries, 301 (47 per cent) had head injuries, 233 (37 per cent) had abdominal injuries and 220 (35 per cent) received injuries to the limbs. Of 121 drivers, 43 (35·5 per cent) died due to chest injuries (steering wheel impact injuries) and out of 292 pedestrians 49 (17 per cent) died of head injuries only. 107 (64·5 per cent) pedestrians, 61 (66 per cent) drivers, 64 (56 per cent) passengers and 15 (52 per cent) on two wheelers were under the influence of alcohol at the time of the accident. 95 (57 per cent) pedestrians, 52 (56·5 per cent) drivers, 46 (40 per cent) passengers and 12 (41 per cent) two wheeler drivers had more than 100 mg% of alcohol in their blood. 427 (68 per cent) victims died of multiple injuries, 77 (12 per cent) died of head injuries, 55 (9 per cent) died of chest injuries, 27 (4 per cent) died of injuries to the abdomen and the other 44 (7 per cent) died of complications.

Hand Injuries as an Indicator of Other Associated Severe Injuries

2007 ◽  
Vol 73 (7) ◽  
pp. 706-708
Author(s):  
Faranak Vossoughi ◽  
Brent Krantz ◽  
Stephen Fann
Keyword(s):  
Motor Vehicle ◽  
Head Injuries ◽  
Skull Fracture ◽  
Rib Fractures ◽  
Motor Vehicle Crash ◽  
Hand Injuries ◽  
Severe Injuries ◽  
Common Cause ◽  
Chest Injuries ◽  
Life Threatening

The purpose of this study was to investigate the incidence of disabling or life-threatening injuries in patients with hand injuries. Retrospective data were collected from a level 1 trauma center registry. A total of 472 patients with hand injuries were admitted to the trauma unit between January 2000 and March 2004. Forty-four per cent of patients with hand injuries had life-threatening injuries. Fifty-one per cent of them had motor vehicle crash-related injuries. Motorcycle crashes were the next most common cause followed by explosions, falls, gunshots, machinery, stabs, bites, crushes, and so on. Frequency of associated injuries was as follows: head injuries, 31 per cent, including skull fractures, 22 per cent; spine injuries, 18 per cent, including spine fractures 18 per cent; chest injuries, 36 per cent, including rib fractures, 15 per cent; and abdominal injuries, 13 per cent. The authors focused on the incidence of disabling or life-threatening injuries in patients with hand injuries. Motor vehicle crashes were most common cause of hand injuries. The most common organs to be injured were chest and head. The most common head injury was skull fracture. Other injuries in decreasing order were spine and rib fractures. These data may be helpful in assessing ambulatory patients in the emergency room, in those hand injuries maybe indicative of other simultaneous life-threatening or disabling injuries.

scholarly journals Recovery from respiratory failure after 49-day extracorporeal membrane oxygenation support in a critically ill patient with COVID-19: case report

2020 ◽  
Author(s):  
Fengwei Guo ◽  
Chao Deng ◽  
Tao Shi ◽  
Yang Yan
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Critically Ill ◽  
Life Support ◽  
Critically Ill Patient ◽  
Hypoxemic Respiratory Failure ◽  
Plasma Therapy ◽  
Form Of Life ◽  
Membrane Oxygenation ◽  
Life Threatening

Abstract Background Respiratory failure is a life-threatening complication of coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome. Extracorporeal membrane oxygenation (ECMO) in COVID-19 might offer promise based on our clinical experience. However, few critically ill cases with COVID-19 have been weaned off ECMO. Case summary A 66-year-old Chinese woman presented with fever (38.9°C), cough, dyspnoea, and headache. She had lymphopenia (0.72 × 109/L) and computed tomography findings of ground-glass opacities. Subsequently, she was confirmed to have respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. She was intubated after transfer to the intensive care unit due to respiratory failure and heart failure. However, her condition continued to deteriorate rapidly. Veno-veno ECMO was undertaken for respiratory and cardiac support due to refractory hypoxemic respiratory failure and bradyarrhythmia (45 b.p.m.). During hospitalization, she was also administered anti-viral treatment, convalescent plasma therapy, and continuous renal replacement therapy. She was maintained on ECMO before she had fully recovered from the condition that necessitated ECMO use and had a negative test for the nucleic acids of SARS-CoV-2 twice. Forty-nine days later, this patient was weaned from ECMO. At the most recent follow-up visit (3 months after weaning from ECMO), she received respiratory and cardiac rehabilitation and did not complain of any discomfort. Discussion As far as we know, the longest duration of ECMO treatment in this critical case with COVID-19 is supportive of ECMO as the most aggressive form of life support and the last line of defence during the COVID-19 epidemic.

scholarly journals Early in-hospital course of critically ill nontrauma patients in a resuscitation room of a German emergency department (OBSERvE2 study)

2021 ◽  
Author(s):  
C. Grahl ◽  
T. Hartwig ◽  
L. Weidhase ◽  
S. Laudi ◽  
S. Petros ◽  
...  
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Critically Ill ◽  
Patient Characteristics ◽  
Therapeutic Interventions ◽  
Hospital Treatment ◽  
Critically Ill Patient ◽  
Time Intervals ◽  
Resuscitation Room ◽  
Life Threatening

Abstract Background Management of critically ill nontrauma (CINT) patients in the resuscitation room of the emergency department (ED) is very challenging. Detailed data describing the patient characteristics and management of this population are lacking. This observational study describes the epidemiology, management and outcome in CINT ED patients in the resuscitation room. Methods This prospective, single center observational study included all adult patients who were consecutively admitted to the ED resuscitation room during 2 periods of 1 year (September 2014–August 2015 vs. September 2017– August 2018). Patient characteristics, out-of-hospital/in-hospital treatment, admission-related conditions, time intervals for diagnostics and interventions and outcome were recorded using a self-developed questionnaire. Results A total of 34,303 patients in the first and 35,039 patients in the second study period were admitted to the ED, of whom 532 and 457 patients, respectively, were admitted to the nontrauma resuscitation room due to acute life-threatening conditions. The patient characteristics did not differ significantly between the study periods (male: 58% vs. 59%, age: 68 ± 17 years vs. 65 ± 17 years). Time intervals for diagnostic and therapeutic interventions were similar. The CINT patients during the second study period were treated faster compared to the first study period (end of ED management: 53 ± 33 min vs. 41 ± 24 min, p < 0.0001). The 30-day all-cause mortality was comparable (34.0% vs. 36.3%). Conclusion Observation of critically ill patient management in the ED resuscitation room showed reliable results between both study periods. Structured ED management guidelines for CINT patients may provide comparable results at one institution.

Hope Is a Thing with Feathers

Save My Kid ◽  
2020 ◽  
pp. 3-23
Author(s):  
Amanda M. Gengler
Keyword(s):  
Critically Ill ◽  
Family Life ◽  
Healthcare Providers ◽  
Critically Ill Children ◽  
Health Capital ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Basic Concepts ◽  
Reproduction Of Inequality

Since families with critically ill children have different resources available to them, they take different approaches to managing their child’s life-threatening illness. The author introduces basic concepts that are analyzed over the course of the book, including care-captaining, which involves working hard to influence the course of their child’s treatment, and care-entrusting, which involves deferring to the judgement of their child’s healthcare providers. Additionally, the chapter covers the topic of healthcare inequality and cultural health capital, emotions and the reproduction of inequality in family life, and more.

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