scholarly journals Quality of interhospital transport of the critically ill: impact of a Mobile Intensive Care Unit with a specialized retrieval team

Critical Care ◽  
2011 ◽  
Vol 15 (1) ◽  
pp. R75 ◽  
Author(s):  
Janke S Wiegersma ◽  
Joep M Droogh ◽  
Jan G Zijlstra ◽  
Janneke Fokkema ◽  
Jack JM Ligtenberg
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Interhospital Transport ◽  
Mobile Intensive Care Unit ◽  
Retrieval Team

Posttraumatic Stress Syndrome Associated With Stays in the Intensive Care Unit: Importance of Nurses’ Involvement

2015 ◽  
Vol 35 (3) ◽  
pp. 44-52 ◽  
Author(s):  
Heather Warlan ◽  
Lois Howland
Keyword(s):  
Intensive Care Unit ◽  
Posttraumatic Stress Disorder ◽  
Intensive Care ◽  
Posttraumatic Stress ◽  
Critically Ill ◽  
Stress Disorder ◽  
Early Mobilization ◽  
Signs And Symptoms ◽  
Posttraumatic Stress Syndrome

More patients in the intensive care unit are surviving their critical illnesses because of advances in medical care. This change in survival has led to an increased awareness of the emotional consequences of being critically ill. Posttraumatic stress disorder has been identified in approximately 9% to 27% of critically ill patients compared with 7% of the general US population. Risk factors such as treatment with mechanical ventilation, sedation, delusional memories, and agitation are associated with development of posttraumatic stress disorder in patients in the intensive care unit. Individuals with posttraumatic stress disorder are more likely to experience negative physical and psychiatric health outcomes and a lower quality of life than are patients without the disorder. Early identification and treatment of patients experiencing these signs and symptoms may reduce these physical and psychological comorbid conditions. Through careful monitoring of medications, early mobilization, sleep promotion, and pain management, nurses may be able to reduce signs and symptoms of posttraumatic stress disorder.

Interhospital transport of the extremely ill patient: The mobile intensive care unit

2000 ◽  
Vol 28 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Mesfin Gebremichael ◽  
Ulf Borg ◽  
Nader M. Habashi ◽  
Christine Cottingham ◽  
Lori Cunsolo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Interhospital Transport ◽  
Mobile Intensive Care Unit

scholarly journals Clinical implications and quality of evidence in metaanalysis about effects of palliative care in critically ill patients in the intensive care unit

2017 ◽  
Vol 15 (5) ◽  
pp. 513-515 ◽  
Author(s):  
Alex Wonnaparhown ◽  
Amaan Shafi ◽  
Xibei Liu ◽  
Angela H. Villamagna ◽  
Michael Lee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Implications ◽  
Quality Of Evidence

Decision-making for children requiring interhospital transport: assessment of a novel triage tool

2021 ◽  
pp. archdischild-2019-318634
Author(s):  
Anthony Slater ◽  
Deanne Crosbie ◽  
Dionne Essenstam ◽  
Brett Hoggard ◽  
Paul Holmes ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Negative Predictive Value ◽  
Critically Ill ◽  
Predictive Value ◽  
Critically Ill Children ◽  
Intensive Care Admission ◽  
Transport Services ◽  
Interhospital Transport ◽  
Retrieval Team

ObjectiveThe use of specialist retrieval teams to transport critically ill children is associated with reduced risk-adjusted mortality and morbidity; however, there is a paucity of data to guide decision-making related to retrieval team activation. We aimed to assess the accuracy of a novel triage tool designed to identify critically ill children at the time of referral for interhospital transport.DesignProspective observational study.SettingRegional paediatric retrieval and transport services.PatientsData were collected for 1815 children referred consecutively for interhospital transport from 87 hospitals in Queensland and northern New South Wales.InterventionImplementation of the Queensland Paediatric Transport Triage Tool.Main outcome measuresAccuracy was assessed by calculating the sensitivity, specificity and negative predictive value for predicting transport by a retrieval team, or admission to intensive care following transport.ResultsA total of 574 (32%) children were transported with a retrieval team. Prediction of retrieval (95% CIs): sensitivity 96.9% (95% CI 95.1% to 98.1%), specificity 91.4% (95% CI 89.7% to 92.9%), negative predictive value 98.4% (95% CI 97.5% to 99.1%). There were 412 (23%) children admitted to intensive care following transport. Prediction of intensive care admission: sensitivity 96.8% (95% CI 94.7% to 98.3%), specificity 81.2% (95% CI 79.0% to 83.2%), negative predictive value 98.9% (95% CI 98.1% to 99.4%).ConclusionsThe triage tool predicted the need for retrieval or intensive care admission with high sensitivity and specificity. The high negative predictive value indicates that, in our setting, children categorised as acutely ill rather than critically ill are generally suitable for interhospital transport without a retrieval team.

scholarly journals Improving Sleep in Intensive Care Unit: An Overview of Diagnostic and Therapeutic Options

2019 ◽  
Vol 7 (5) ◽  
pp. 697-702
Author(s):  
Ravindranath Tiruvoipati ◽  
Juan Mulder ◽  
Kavi Haji
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sleep Quality ◽  
Critically Ill ◽  
Poor Quality ◽  
Quality Of Sleep ◽  
Pharmacological Agents ◽  
Quality Sleep ◽  
Assess Quality

Good quality sleep is considered to be essential for healthy living and recovering from illness. It would be logical to think that good quality sleep is most required when a patient is critically ill in an intensive care unit (ICU). Several studies have demonstrated poor quality of sleep while the patients are in ICU. Subjective tools such as questionnaires while simple are unreliable to accurately assess sleep quality. Relatively few studies have used standardized polysomnography. The use of novel biological markers of sleep such as serum brain-derived neurotrophic factor concentrations may help in conjunction with polysomnography to assess sleep quality in critically ill patients. Attempts to improve sleep included nonpharmacological interventions including the use of earplugs, eye sleep masks, and pharmacological agents including ketamine, propofol, dexmedetomidine, and benzodiazepines. The evidence for these interventions remains unclear. Further research is needed to assess quality of sleep and improve the sleep quality in intensive care settings.

scholarly journals Prophylactic Haloperidol Effects on Long-term Quality of Life in Critically Ill Patients at High Risk for Delirium

2019 ◽  
Vol 131 (2) ◽  
pp. 328-335
Author(s):  
Paul J. T. Rood ◽  
Marieke Zegers ◽  
Arjen J. C. Slooter ◽  
Albert Beishuizen ◽  
Koen S. Simons ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Placebo Group ◽  
High Risk ◽  
Critically Ill ◽  
Mental Component Summary ◽  
Long Term Outcomes

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Delirium incidence in intensive care unit patients is high and associated with impaired long-term outcomes. The use of prophylactic haloperidol did not improve short-term outcome among critically ill adults at high risk of delirium. This study evaluated the effects of prophylactic haloperidol use on long-term quality of life in this group of patients and explored which factors are associated with change in quality of life. Methods A preplanned secondary analysis of long-term outcomes of the pRophylactic haloperidol usE for DeliriUm in iCu patients at high risk for dElirium (REDUCE) study was conducted. In this multicenter randomized clinical trial, nondelirious intensive care unit patients were assigned to prophylactic haloperidol (1 or 2 mg) or placebo (0.9% sodium chloride). In all groups, patients finally received study medication for median duration of 3 days [interquartile range, 2 to 6] until onset of delirium or until intensive care unit discharge. Long-term outcomes were assessed using the Short Form-12 questionnaire at intensive care unit admission (baseline) and after 1 and 6 months. Quality of life was summarized in the physical component summary and mental component summary scores. Differences between the haloperidol and placebo group and factors associated with changes in quality of life were analyzed. Results Of 1,789 study patients, 1,245 intensive care unit patients were approached, of which 887 (71%) responded. Long-term quality of life did not differ between the haloperidol and placebo group (physical component summary mean score of 39 ± 11 and 39 ± 11, respectively, and P = 0.350; and mental component summary score of 50 ± 10 and 51 ± 10, respectively, and P = 0.678). Age, medical and trauma admission, quality of life score at baseline, risk for delirium (PRE-DELIRIC) score, and the number of sedation-induced coma days were significantly associated with a decline in long-term quality of life. Conclusions Prophylactic haloperidol use does not affect long-term quality of life in critically ill patients at high risk for delirium. Several factors, including the modifiable factor number of sedation-induced coma days, are associated with decline in long-term outcomes.

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