Short-Term Ventilation of Critically Ill Patients in Recovery

2003 ◽  
Vol 13 (5) ◽  
pp. 214-217 ◽  
Author(s):  
David Ryan ◽  
Gillian Tobin

There is often a shortfall of critical care facilities which can result in a number of patients who need management in intensive care units (ICUs) being treated in a recovery unit prior to being found an ICU bed. This article describes a study which examined this situation. The patients’ origins, durations of stay in recovery, outcomes and final destinations are discussed. The authors conclude that recovery provides a hidden resource to supplement the lack of intensive care beds and suggest ways that the problem might be addressed.

2020 ◽  
Vol 29 (5) ◽  
pp. e104-e107
Author(s):  
Diana Brickman ◽  
Andrew Greenway ◽  
Kathryn Sobocinski ◽  
Hanh Thai ◽  
Ashley Turick ◽  
...  

Background In response to the coronavirus pandemic, New York State mandated that all hospitals double the capacity of their adult intensive care units In this facility, resources were mobilized to increase from 104 to 283 beds. Objective To create and implement a 3-hour curriculum to prepare several hundred non–critical care staff nurses to manage critically ill patients with coronavirus disease 2019. Methods Critical care nursing leaders and staff developed and implemented a flexible critical care nursing curriculum tailored to the diverse experience, expertise, and learning needs of non–critical care nursing staff who were being redeployed to critical care units during the surge response to the pandemic. Curricular elements included respiratory failure and ventilator management, shock and hemodynamics, pharmacotherapy for critical illnesses, and renal replacement therapy. A skills station allowed hands-on practice with common critical care equipment. Results A total of 413 nurses completed training within 10 days. As of June 2020, 151 patients with coronavirus disease 2019 still required mechanical ventilation at our institution, and 7 of 10 temporary intensive care units remained operational. Thus most of the nurses who received this training continued to practice critical care. A unique feature of this curriculum was the tailored instruction, adapted to learners’ needs, which improved the efficiency of content delivery. Conclusions Program evaluation is ongoing. As recovery and restoration proceed and normal operations resume, detailed feedback from program participants and patient care managers will help the institution maintain high operational readiness should a second wave of critically ill patients with coronavirus disease 2019 be admitted.


2001 ◽  
Vol 2 (3-4) ◽  
pp. 6-8 ◽  
Author(s):  
Lynn Sealey

When high dependency and intensive care units are full, which occurs more and more often nationally, recovery wards are being utilised to hold critically ill patients. Recovery practitioners are often expected to assist in the care of these patients.A small study established the views of a sample of recovery practitioners regarding the recovery unit being used as stop-gap, or ICU overflow. There were positive and negative opinions from recovery practitioners who were involved in the care of these critically ill patients. Recovery practitioners often reported feeling inexperienced and ill equipped, with increased levels of stress when working in the ICU bay. Only 20% of recovery practitioners in the study, expressed optimism about working in the ICU bay, and 60% identified that training and development was a strategy which may help to overcome some of their perceived problems.This paper reports these concerns and identifies strategies which have been implemented to address some of these concerns.


2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Ludmila Silva Castanheira ◽  
Andreza Werli-Alvarenga ◽  
Allana Dos Reis Correa ◽  
Daniela Mascarenhas de Paula Campos

Resumo: Feridas afetam a integridade da pele, e quando não prevenidas ou tratadas podem levar a complicações decorrentes da integridade da pele prejudicada, especialmente em Unidades de Terapia Intensiva (UTIs). Atualmente, as escalas de predição de risco disponíveis para esta avaliação e validadas para o português são as de Braden, Waterlow e Norton. Objetivo: determinar qual a escala mais acurada para a avaliação de pacientes criticamente enfermos. Metodologia: Trata-se de uma revisão integrativa, cuja questão norteadora foi: qual escala para predição de risco para LP, disponível e validada para o português é mais acurada para estimar o risco de LP em pacientes criticamente enfermos internados na UTI? A busca dos estudos foi realizada na BVS, PubMed/MedLine e CINAHL. Resultados: Foram encontrados 134 artigos, elegíveis 123 e incluídos 18 na revisão. Conclusão: Os resultados apontam a necessidade da realização de estudos nesta área.Descritores: Úlcera por Pressão; Unidades de Terapia Intensiva; Cuidados Críticos; EscalasPREDICTION RISK SCALES FOR PRESSURE INJURY IN CRITICALLY ILL PATIENTS INTEGRATIVE REVIEWSummary: Wounds affect skin integrity, and when not prevented or treated can lead to complications resulting from impaired skin integrity, especially in intensive care units (ICUs). Currently, the prediction of risk scales available for this evaluation and validated for the Portuguese are Braden, Waterlow and Norton. Objective: to determine what the more accurate scale for the assessment of critically ill. Methodology: it is an integrative review, whose guiding question was: which to scale for risk prediction for LP, available and validated to Portuguese is more accurate for estimating the risk of LP in critically ill hospitalized in ICU? The search of the studies was held at the BVS, PubMed/MedLine and CINAHL. Results: found 134 items, 123 and included 18 eligible in the review. Conclusion: the results show the need of carrying out studies in this area.Descriptors: Pressure ulcer; Intensive Care Units; Critical Care; ScalesESCALAS DE PREDICCIÓN DE RIESGO PARA LESIÓN POR PRESIÓN EN PACIENTES CRÍTICAMENTE ENFERMOS: REVISIÓN INTEGRATIVAResumen: Las heridas afectan la integridad de la piel y cuando no prevenido o Tratado pueden conducir a las complicaciones resultantes de la integridad de la piel deteriorada, especialmente en unidades de cuidados intensivos (UCI). Actualmente, la predicción de las escalas de riesgo disponibles para esta evaluación y validadas para los portugueses son Braden, Waterlow y Norton. Objetivo: determinar la escala que más precisa para la evaluación de estado crítico. Metodología: ¿ es un examen integrador, cuyo rector era: que a la escala de predicción de riesgo de LP, disponible y validado al portugués es más exacta para estimar el riesgo de LP en críticamente enfermos hospitalizados en UCI? La búsqueda de los estudios se realizó en la BVS, PubMed/MedLine y CINAHL. Resultados: elegibles 18 134 artículos encontrados, 123 e incluido en la revisión. Conclusión: los resultados muestran la necesidad de llevar a cabo estudios en esta área.Descriptores: Úlcera por Presión, Unidades de Cuidados Intensivos, Cuidados Críticos, Escalas.


Author(s):  
M. Ostermann ◽  
A. Schneider ◽  
T. Rimmele ◽  
I. Bobek ◽  
M. van Dam ◽  
...  

Abstract Purpose Critical Care Nephrology is an emerging sub-specialty of Critical Care. Despite increasing awareness about the serious impact of acute kidney injury (AKI) and renal replacement therapy (RRT), important knowledge gaps persist. This report represents a summary of a 1-day meeting of the AKI section of the European Society of Intensive Care Medicine (ESICM) identifying priorities for future AKI research. Methods International Members of the AKI section of the ESICM were selected and allocated to one of three subgroups: “AKI diagnosis and evaluation”, “Medical management of AKI” and “Renal Replacement Therapy for AKI.” Using a modified Delphi methodology, each group identified knowledge gaps and developed potential proposals for future collaborative research. Results The following key research projects were developed: Systematic reviews: (a) epidemiology of AKI with stratification by patient cohorts and diagnostic criteria; (b) role of higher blood pressure targets in patients with hypertension admitted to the Intensive Care Unit, and (c) specific clearance characteristics of different modalities of continuous renal replacement therapy (CRRT). Observational studies: (a) epidemiology of critically ill patients according to AKI duration, and (b) current clinical practice of CRRT. Intervention studies:( a) Comparison of different blood pressure targets in critically ill patients with hypertension, and (b) comparison of clearance of solutes with various molecular weights between different CRRT modalities. Conclusion Consensus was reached on a future research agenda for the AKI section of the ESICM.


2020 ◽  
Vol 13 (9) ◽  
pp. 550-556
Author(s):  
Minal Karavadra ◽  
Ricky Bell

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.


2020 ◽  
Vol 10 (4) ◽  
pp. 72
Author(s):  
Mohamed E. Abdelgawad ◽  
Nadia T. Ahmed ◽  
Ahmed M. Elmenshawy

Background and objective: Electrolyte disturbances remain a common lifesaving issue in the intensive care units. They are associated with increased morbidity and mortality. They are mostly resulted secondary to critical illness itself or associated treatment modalities. Therefore, electrolytes repletion should be done effectively and timely. This could be ensured using nurse driven protocols rather than traditional methods of repletion. These protocols are nurse initiated and collaboratively developed. They have been shown to improve patient care outcomes through the provision of high quality care. They are increasingly being used in the critical care setting. Objective: Determine the effect of applying nurses driven electrolytes repletion protocol on electrolytes disturbance control among critically ill patients.Methods: Quasi experimental research design was used. Sixty two critically ill patients with electrolytes loss were enrolled in the study at Alexandria Main University Hospital intensive care units, Egypt. All episodes of electrolyte loss were evaluated. Repletion of electrolyte loss was done according to unit routine for the control group and nurses driven electrolytes repletion protocol for the study group. Episodes of electrolyte disturbances, adverse events and timing of repletion were evaluated.Results: Neurological disorders represent the most encountered diagnosis. The most common cause of electrolyte loss in was the use of diuretics. Furthermore, there was a highly statistical difference between the two groups as regard electrolytes levels, effectiveness and timing of replacement.Conclusions: Application of nurses driven electrolyte repletion protocol resulted in improvements in the effectiveness and timeliness of electrolyte replacement.


2009 ◽  
Vol 16 (10) ◽  
pp. 1527-1528 ◽  
Author(s):  
Rafael Zaragoza ◽  
Javier Pemán ◽  
Guillermo Quindós ◽  
Jose R. Iruretagoyena ◽  
María S. Cuétara ◽  
...  

ABSTRACT The influence of kinetic patterns of Candida albicans germ tube antibodies (CAGTA) on mortality was analyzed in six intensive care units. Statistically significant lower mortality rates were found in patients with patterns of increasing CAGTA titers who had been treated with antifungal agents. Thus, antifungal treatment should be considered when CAGTA titers are increasing in critically ill patients.


2021 ◽  
Vol 1 (3) ◽  
pp. 44-48
Author(s):  
Cendy Legowo

Perioperative delirium is a wide-ranging problem that directly affects primary clinical results. The anesthesiologist must understand how to define and diagnose delirium, identify patients at high risk of delirium, identify predisposing factors to adjust the care plan appropriately, and manage delirium in the acute postoperative period. Delirium is an organ dysfunction in critically ill patients, independently associated with improved morbidity. Research on delirium in hospitalized patients (including critically ill patients) has increased exponentially in the last decade. This study emphasizes the need for a mechanistic explanation of delirium to help advance the research that ultimately leads to its prevention and treatment. In this study, multinational and multidisciplinary clinicians, and researchers from the fields of critical care medicine, psychiatry, anesthesiology, neurology, and pharmacy sought to collaborate in the management of delirium in the intensive care unit (ICU).


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