scholarly journals Pakistan Registry of Intensive CarE (PRICE): Expanding a lower middle-income, clinician-designed critical care registry in South Asia

2018 ◽  
Vol 20 (3) ◽  
pp. 190-195 ◽  
Author(s):  
M Hashmi ◽  
A Beane ◽  
A Taqi ◽  
MI Memon ◽  
P Athapattu ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Real Time ◽  
National Registry ◽  
Service Improvement ◽  
Intensive Care Society ◽  
Middle Income ◽  
Resource Limited ◽  
Care Systems ◽  
And Training

Introduction In resource-limited settings – with inequalities in access to and outcomes for trauma, surgical and critical care – intensive care registries are uncommon. Aim The Pakistan Society of Critical Care Medicine, Intensive Care Society (UK) and the Network for Improving Critical Care Systems and Training (NICST) aim to implement a clinician-led real-time national intensive care registry in Pakistan: the Pakistan Registry of Intensive CarE (PRICE). Method This was adapted from a successful clinician co-designed national registry in Sri Lanka; ICU information has been linked to real-time dashboards, providing clinicians and administrators individual patient and service delivery activity respectively. Output Commenced in August 2017, five ICU’s (three administrative regions – 104 beds) were recruited and have reported over 1100 critical care admissions to PRICE. Impact and future PRICE is being rolled out nationally in Pakistan and will provide continuous granular healthcare information necessary to empower clinicians to drive setting-specific priorities for service improvement and research.

scholarly journals Leveraging a Cloud-Based Critical Care Registry for COVID-19 Pandemic Surveillance and Research in Low- and Middle-Income Countries (Preprint)

2020 ◽  
Author(s):  
◽  
Madiha Hashmi ◽  
Abi Beane ◽  
Srinivas Murthy ◽  
Arjen M Dondorp ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Intensive Care ◽  
Real Time ◽  
Sub Saharan Africa ◽  
Common Data Model ◽  
Middle Income ◽  
Middle Income Countries ◽  
Severe Acute Respiratory Infection ◽  
Low And Middle Income

UNSTRUCTURED The COVID-19 pandemic has revealed limitations in real-time surveillance needed for responsive health care action in low- and middle-income countries (LMICs). The Pakistan Registry for Intensive CarE (PRICE) was adapted to enable International Severe Acute Respiratory and emerging Infections Consortium (ISARIC)–compliant real-time reporting of severe acute respiratory infection (SARI). The cloud-based common data model and standardized nomenclature of the registry platform ensure interoperability of data and reporting between regional and global stakeholders. Inbuilt analytics enable stakeholders to visualize individual and aggregate epidemiological, clinical, and operational data in real time. The PRICE system operates in 5 of 7 administrative regions of Pakistan. The same platform supports acute and critical care registries in eleven countries in South Asia and sub-Saharan Africa. ISARIC-compliant SARI reporting was successfully implemented by leveraging the existing PRICE infrastructure in all 49 member intensive care units (ICUs), enabling clinicians, operational leads, and established stakeholders with responsibilities for coordinating the pandemic response to access real-time information on suspected and confirmed COVID-19 cases (N=592 as of May 2020) via secure registry portals. ICU occupancy rates, use of ICU resources, mechanical ventilation, renal replacement therapy, and ICU outcomes were reported through registry dashboards. This information has facilitated coordination of critical care resources, health care worker training, and discussions on treatment strategies. The PRICE network is now being recruited to international multicenter clinical trials regarding COVID-19 management, leveraging the registry platform. Systematic and standardized reporting of SARI is feasible in LMICs. Existing registry platforms can be adapted for pandemic research, surveillance, and resource planning.

scholarly journals Leveraging a Cloud-Based Critical Care Registry for COVID-19 Pandemic Surveillance and Research in Low- and Middle-Income Countries

10.2196/21939 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e21939
Author(s):  
◽  
Madiha Hashmi ◽  
Abi Beane ◽  
Srinivas Murthy ◽  
Arjen M Dondorp ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Intensive Care ◽  
Real Time ◽  
Sub Saharan Africa ◽  
Common Data Model ◽  
Middle Income ◽  
Middle Income Countries ◽  
Severe Acute Respiratory Infection ◽  
Low And Middle Income

The COVID-19 pandemic has revealed limitations in real-time surveillance needed for responsive health care action in low- and middle-income countries (LMICs). The Pakistan Registry for Intensive CarE (PRICE) was adapted to enable International Severe Acute Respiratory and emerging Infections Consortium (ISARIC)–compliant real-time reporting of severe acute respiratory infection (SARI). The cloud-based common data model and standardized nomenclature of the registry platform ensure interoperability of data and reporting between regional and global stakeholders. Inbuilt analytics enable stakeholders to visualize individual and aggregate epidemiological, clinical, and operational data in real time. The PRICE system operates in 5 of 7 administrative regions of Pakistan. The same platform supports acute and critical care registries in eleven countries in South Asia and sub-Saharan Africa. ISARIC-compliant SARI reporting was successfully implemented by leveraging the existing PRICE infrastructure in all 49 member intensive care units (ICUs), enabling clinicians, operational leads, and established stakeholders with responsibilities for coordinating the pandemic response to access real-time information on suspected and confirmed COVID-19 cases (N=592 as of May 2020) via secure registry portals. ICU occupancy rates, use of ICU resources, mechanical ventilation, renal replacement therapy, and ICU outcomes were reported through registry dashboards. This information has facilitated coordination of critical care resources, health care worker training, and discussions on treatment strategies. The PRICE network is now being recruited to international multicenter clinical trials regarding COVID-19 management, leveraging the registry platform. Systematic and standardized reporting of SARI is feasible in LMICs. Existing registry platforms can be adapted for pandemic research, surveillance, and resource planning.

Oxford Desk Reference: Critical Care

2019 ◽  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Best Practice ◽  
Tissue Perfusion ◽  
Access To Information ◽  
Cardiovascular Monitoring ◽  
Self Assessment ◽  
And Training ◽  
Desk Reference ◽  
Assessment Questions

Oxford Desk Reference: Critical Care second edition is a clinical guide reflecting best practice and training pathways. Each topic is laid out in a concise entry, allowing rapid access to information. The second edition includes new sections on tissue perfusion monitoring and paediatric and maternal critical care, as well as expanded coverage of cardiovascular monitoring, myocardial infarction, and respiratory therapy techniques. New self-assessment questions support FFICM (Fellow of the Faculty of Intensive Care Medicine) and EDIC (European Diploma of Intensive Care) revision as well as continuing medical education reflection. Covering the entire discipline in an easy-to-read format, this is the definitive clinical reference for critical care, ideal for trainees, consultants, advanced care practitioners, and nurses.

scholarly journals Advanced Critical Care Practitioners – Practical experience of implementing the Advanced Critical Care Practitioner Faculty of Intensive Care Medicine Curriculum in a London Critical Care Unit

2017 ◽  
Vol 19 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Geraldine Lee ◽  
Jo-Anne Gilroy ◽  
Alistair Ritchie ◽  
Vimal Grover ◽  
Keetje Gull ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Medicine ◽  
Practical Experience ◽  
Advanced Practice ◽  
Clinical Role ◽  
Shortage Of Doctors ◽  
Practitioner Faculty ◽  
And Training

With a chronic shortage of doctors in intensive care, alternative roles are being explored. One of these is the role of the Advanced Critical Care Practitioner. The Advanced Critical Care Practitioner Curriculum was developed by the Faculty of Intensive Care Medicine and is used to provide a structured programme of training. The Advanced Critical Care Practitioner programme consists of an academic and clinical component. This article outlines a practical approach of how the programme was developed and is currently being delivered at a single institution. This new advanced practice role offers opportunities to fill gaps in the medical workforce, improve continuity of patient care, provide mentoring and training for less experienced staff as well as offering a rewarding clinical role.

scholarly journals Lessons for intensive care units in COVID-19 pandemic-moving towards sustainability

2020 ◽  
Vol 7 (3) ◽  
pp. 1
Author(s):  
Prashant Nasa ◽  
Ruchi Nasa ◽  
Aanchal Singh
Keyword(s):  
Critical Care ◽  
Supply Chain ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Standard Of Care ◽  
Infrastructure Development ◽  
Care Providers ◽  
Care Services ◽  
Second Wave ◽  
And Training

The Coronavirus disease-2019 (COVID-19) pandemic has inundated critical care services globally. The intensive care units (ICUs) and critical care providers have been forefront of this pandemic, evolving continuously from experiences and emerging evidence. In this review, we discuss the key lessons from the ongoing wave of COVID-19 pandemic and preparations for a future surge or second wave. The model of sustainable critical care services should be based on 1) infrastructure development, 2) preparation and training of manpower, 3) implementing standard of care and infection control, 4) sustained supply-chain and finally, and 5) surge planning. 

scholarly journals Incorporating point-of-care ultrasound into daily intensive care unit rounds: Another source of interruptions?

2018 ◽  
Vol 21 (1) ◽  
pp. 18-21
Author(s):  
O Olusanya ◽  
AVK Wong ◽  
J Kirk-Bayley ◽  
P Parulekar
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Online Survey ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Clinical Decisions ◽  
Bedside Ultrasonography ◽  
Ward Rounds ◽  
And Training

Point-of-care ultrasound (POCUS) is the use of bedside ultrasonography by the treating clinician, incorporating those images into direct clinical decisions. While there are a number of different techniques and training pathways in this relatively new modality, there has been little discussion around the logistics of integrating POCUS into the standard critical care “business day” of ward rounds, procedures and meetings. This article explores some of these aspects and presents data from an online survey of POCUS practitioners.

scholarly journals CRITCON-Pandemic levels: A stepwise ethical approach to clinician responsibility

2020 ◽  
pp. 175114372095054
Author(s):  
Dan Harvey ◽  
Dale Gardiner ◽  
Andrew McGee ◽  
Thearina DeBeer ◽  
David Shaw
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Operational Matrix ◽  
Ethical Principle ◽  
Intensive Care Society ◽  
Care Society ◽  
Legal Principles ◽  
Ethical Approach ◽  
Care Activity ◽  
Practical Guidance

CRITCON-Pandemic levels with an associated operational responsibility matrix were recently published by the Intensive Care Society as a modification to Winter Flu CRITCON levels, to better account for differences between a winter flu surge in critical care activity and the capacity challenges of the COVID-19 pandemic. In this paper, we propose an expansion and explanation of the operational matrix to suggest a stepwise ethical approach to clinician responsibility. We propose and outline the main ethical risks created at each level and discuss how those risks can be mitigated through a balanced application of the predominant ethical principle which in turn provides practical guidance to clinician responsibility. We thus seek to specify the ethical and legal principles that should be used in applying the operational matrix, and what the practical effects could be.

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