Current Practice, Demographics, and Trends of Critical Care Trained Emergency Physicians in the United States

Anesthesiologists are increasingly confronting the difficult problem of caring for patients with sepsis in the operating room and in the intensive care unit. Sepsis occurs in more than 750,000 patients in the United States annually and is responsible for more than 210,000 deaths. Approximately 40% of all intensive care unit patients have sepsis on admission to the intensive care unit or experience sepsis during their stay in the intensive care unit. There have been significant advances in the understanding of the pathophysiology of the disorder and its treatment. Although deaths attributable to sepsis remain stubbornly high, new treatment algorithms have led to a reduction in overall mortality. Thus, it is important for anesthesiologists and critical care practitioners to be aware of these new therapeutic regimens. The goal of this review is to include practical points on important advances in the treatment of sepsis and provide a vision of future immunotherapeutic approaches.

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The utility of ‘home-made’ reagent red blood cells for antibody screening during pre-transfusion compatibility testing in Uganda

African Health Sciences ◽

10.4314/ahs.v21i2.38 ◽

2021 ◽

Vol 21 (2) ◽

pp. 782-787

Author(s):

Bernard Natukunda ◽

Robert Wagubi ◽

Ivan Taremwa ◽

Benson Okongo ◽

Yona Mbalibulha ◽

...

Keyword(s):

United States ◽

Blood Cells ◽

Current Practice ◽

The United States ◽

Extended Phenotype ◽

Female Ratio ◽

Fusion Safety ◽

Indirect Antiglobulin Test ◽

Antiglobulin Test ◽

Male To Female

Background: The WHO recommends that pre-transfusion testing should include ABO/RhD grouping followed by screen- ing for red blood cell (RBC) alloantibodies using the indirect antiglobulin test (IAT). However, in Uganda, current practice does not include RBC alloantibody screening. Objective: To assess the utility of ‘home-made’ reagent RBCs in alloantibody screening. Materials and methods: In a laboratory-based study, group O RhD positive volunteer donors were recruited and their extended phenotype performed for C, c, E, e, K, Fya, Fyb Jkb, S and s antigens. These ‘home-made’ reagent RBCs were preserved using Alsever’s solution and alloantibody detection tests performed. For quality assurance, repeat alloantibody screening of patients’ samples was done at Bloodworks Northwest Laboratory in Seattle, United States. Results: A total of 36 group O RhD positive individuals were recruited as reagent RBC donors (median age, 25 years; range, 21 – 58 years; male-to-female ratio, 1.6:1). Out of the 311 IATs performed, 32 (10.3%) were positive. Confirmatory IAT testing in the United States was in agreement with the findings in Uganda. Conclusion: Use of ‘home-made’ reagent RBCs during pre-transfusion testing in Uganda is feasible. We recommend the introduction of pre-transfusion IAT alloantibody screening in Uganda using ‘home-made’ reagent RBCs to improve trans- fusion safety. Keywords: Blood transfusion; ‘Home-made’ reagent RBCs; Pre-transfusion testing; RBC alloantibody screening; Uganda.

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Neonatal Personpower

PEDIATRICS ◽

10.1542/peds.79.5.836 ◽

1987 ◽

Vol 79 (5) ◽

pp. 836-837

Author(s):

GERALD KATZMAN

Keyword(s):

United States ◽

Critical Care ◽

The United States ◽

Care Needs ◽

Live Births ◽

Adequate Number ◽

Lengths Of Stay ◽

The Difference ◽

Power Needs

To the Editor.— There have been several attempts to define the person-power needs for neonatologists in the United States.1-3 The reports by Merenstein et al2 and the AAP Committee on Fetus and Newborn1 maintain that there is presently an adequate number of neonatologists, whereas in a 1981 editorial, Robertson3 predicted increasing shortages of neonatologists. Why the difference between the conclusions? My answer to this question is that the reports by Merenstein et al and the AAP used calculated ratios of neonatologists to live births or lengths of stay, whereas the Robertson editorial expressed concern about the critical care needs of the physiologically unstable neonate.

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Workforce demographics and unit structure in paediatric cardiac critical care in the United States

Cardiology in the Young ◽

10.1017/s1047951121004753 ◽

2021 ◽

pp. 1-5

Author(s):

Robin V. Horak ◽

Shasha Bai ◽

Bradley S. Marino ◽

David K. Werho ◽

Leslie A. Rhodes ◽

...

Keyword(s):

United States ◽

Critical Care ◽

Heart Surgery ◽

Age Groups ◽

The United States ◽

Work Hours ◽

Full Time ◽

Full Time Equivalent ◽

Unit Structure ◽

Cardiac Critical Care

Abstract Objective: To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States. Design: REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure. Measurements and main results: Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%). Conclusions: Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.

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C. The Determination of Taxable Income: A Comparison of the CCCTB Proposal and Current Practice in the EU Member States, Switzerland and the United States

Common Corporate Tax Base (CC(C)TB) and Determination of Taxable Income ◽

10.1007/978-3-642-28433-5_3 ◽

2012 ◽

pp. 17-84

Author(s):

Christoph Spengel ◽

York Zöllkau

Keyword(s):

United States ◽

Current Practice ◽

The United States ◽

Member States ◽

Taxable Income ◽

Eu Member States ◽

The Eu

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