Implementation of a Surgical Critical Care Service Reduces Failure to Rescue in Emergency Gastrointestinal Surgery in Rural Kenya

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Heath R. Many ◽  
Kemunto Otoki ◽  
Andrea S. Parker ◽  
Robert K. Parker
Keyword(s):  
Critical Care ◽  
Care Service ◽  
Gastrointestinal Surgery ◽  
Failure To Rescue ◽  
Critical Care Service ◽  
Surgical Critical Care ◽  
Rural Kenya

scholarly journals Telemedicine coverage for post-operative ICU patients

2016 ◽  
Vol 23 (2) ◽  
pp. 360-364 ◽  
Author(s):  
Tara Ann Collins ◽  
Matthew P Robertson ◽  
Corinna P Sicoutris ◽  
Michael A Pisa ◽  
Daniel N Holena ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Care Service ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Surge Capacity ◽  
Icu Patients ◽  
Critical Care Service ◽  
Surgical Critical Care

Introduction There is an increased demand for intensive care unit (ICU) beds. We sought to determine if we could create a safe surge capacity model to increase ICU capacity by treating ICU patients in the post-anaesthesia care unit (PACU) utilizing a collaborative model between an ICU service and a telemedicine service during peak ICU bed demand. Methods We evaluated patients managed by the surgical critical care service in the surgical intensive care unit (SICU) compared to patients managed in the virtual intensive care unit (VICU) located within the PACU. A retrospective review of all patients seen by the surgical critical care service from January 1st 2008 to July 31st 2011 was conducted at an urban, academic, tertiary centre and level 1 trauma centre. Results Compared to the SICU group ( n = 6652), patients in the VICU group ( n = 1037) were slightly older (median age 60 (IQR 47–69) versus 58 (IQR 44–70) years, p = 0.002) and had lower acute physiology and chronic health evaluation (APACHE) II scores (median 10 (IQR 7–14) versus 15 (IQR 11–21), p < 0.001). The average amount of time patients spent in the VICU was 13.7 + /–9.6 hours. In the VICU group, 750 (72%) of patients were able to be transferred directly to the floor; 287 (28%) required subsequent admission to the surgical intensive care unit. All patients in the VICU group were alive upon transfer out of the PACU while mortality in the surgical intensive unit cohort was 5.5%. Discussion A collaborative care model between a surgical critical care service and a telemedicine ICU service may safely provide surge capacity during peak periods of ICU bed demand. The specific patient populations for which this approach is most appropriate merits further investigation.

scholarly journals 167: NURSING EXPERIENCES OF NOVEL SURGICAL CRITICAL CARE SERVICE IMPLEMENTATION DURING COVID-19 PANDEMIC

2021 ◽  
Vol 50 (1) ◽  
pp. 67-67
Author(s):  
Elizabeth Sheridan ◽  
Niels Martin ◽  
Melissa Dunlop ◽  
Jason Saucier ◽  
Christopher Huot ◽  
...  
Keyword(s):  
Critical Care ◽  
Care Service ◽  
Critical Care Service ◽  
Surgical Critical Care

scholarly journals Critical care service delivery across healthcare systems in low-income and low-middle-income countries: protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048423
Author(s):  
Andrew George Lim ◽  
Sean Kivlehan ◽  
Lia Ilona Losonczy ◽  
Srinivas Murthy ◽  
Enrico Dippenaar ◽  
...  
Keyword(s):  
Critical Care ◽  
Service Delivery ◽  
Low Income ◽  
Full Text ◽  
Care Service ◽  
Middle Income ◽  
Middle Income Countries ◽  
Critical Care Service ◽  
Care Services ◽  
Low Middle Income Countries

IntroductionCritical care in low-income and low-middle income countries (LLMICs) is an underdeveloped component of the healthcare system. Given the increasing growth in demand for critical care services in LLMICs, understanding the current capacity to provide critical care is imperative to inform policy on service expansion. Thus, our aim is to describe the provision of critical care in LLMICs with respect to patients, providers, location of care and services and interventions delivered.Methods and analysisWe will search PubMed/MEDLINE, Web of Science and EMBASE for full-text original research articles available in English describing critical care services that specify the location of service delivery and describe patients and interventions. We will restrict our review to populations from LLMICs (using 2016 World Bank classifications) and published from 1 January 2008 to 1 January 2020. Two-reviewer agreement will be required for both title/abstract and full text review stages, and rate of agreement will be calculated for each stage. We will extract data regarding the location of critical care service delivery, the training of the healthcare professionals providing services, and the illnesses treated according to classification by the WHO Universal Health Coverage Compendium.Ethics and disseminationReviewed and exempted by the Stanford University Office for Human Subjects Research and IRB on 20 May 2020. The results of this review will be disseminated through scholarly publication and presentation at regional and international conferences. This review is designed to inform broader WHO, International Federation for Emergency Medicine and partner efforts to strengthen critical care globally.PROSPERO registration numberCRD42019146802.

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