scholarly journals Early physiotherapeutic interventions in Intensive Care Units

2017 ◽  
Vol 64 (1) ◽  
pp. 15-20
Author(s):  
Sanja Tomic ◽  
Jovan Matijasevic ◽  
Ilija Andrijevic ◽  
Dragana Milutinovic
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Early Rehabilitation ◽  
Social Functions ◽  
Limited Mobility ◽  
Personalized Approach ◽  
Therapy Interventions ◽  
General Physical

Physical morbidity represents the deterioration of the general physical condition and it occurs as a result of illness and/or injury. When this condition is combined with acute diseases and limited mobility it is followed by a large number of complications that usually occur in patients treated in Intensive Care Units (ICU). Its treatment demands a comprehensive approach and early rehabilitation of the critically ill patients aimed at achieving the highest possible level of functionality within the boundaries of what is permitted by the illness/injury and its treatment. However, the prolonged period of immobilization of the critically ill is followed by shorter and/or longer periods of sequelae during and after treatment. The most common sequelae include physical deficits or psycho-emotional problems associated with PICS (post intensive care syndrome). General recommendations for early rehabilitation in the ICU undoubtedly point to the need of introducing physical therapy interventions as soon as possible, that is, as soon as the patient?s medical condition permits it. The primary goal of early rehabilitation of the critically ill during their stay in the ICU is to maximize the restoration of physical, psycho-emotional and social functions by implementing a personalized approach that reflects the needs of the patient.

scholarly journals Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana

2021 ◽  
Author(s):  
Alhassan Sibdow Abukari ◽  
Angela Kwartemaa Acheampong
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Teaching Hospitals ◽  
Critically Ill Children ◽  
Feeding Method ◽  
Tertiary Teaching ◽  
Critically Ill Child ◽  
Descriptive Qualitative

Abstract Background: Critically ill children require optimum feeding in the intensive care for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units.Methods: A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N=42).Results: The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children.Conclusions: Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU is recommended to reduce possible infant and child mortality resulting from feeding.

scholarly journals Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units

2019 ◽  
Vol 35 (11) ◽  
pp. 1271-1277
Author(s):  
Dora Wood ◽  
Sophie Geoghegan ◽  
Padmanabhan Ramnarayan ◽  
Peter J. Davis ◽  
Lyvonne Tume ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Pediatric Intensive Care ◽  
Emotional Impact ◽  
Framework Analysis ◽  
Pediatric Intensive Care Units ◽  
Medical Needs ◽  
The Impact

Purpose: In the United Kingdom, critically ill adolescents are treated in either adult or pediatric intensive care units (AICUs or PICUs). This study explores staff perspectives on where and how best to care for this distinct group. Materials and Methods: Semistructured interviews were conducted with 12 members of staff (3 medical, 6 nursing, and 3 allied health professionals) working in 4 ICUs; 2 general hospital AICUs and 2 tertiary centre–based PICUs in England. Interviews were audio-recorded, transcribed, and analyzed using framework analysis. Findings: One overarching theme was identified, reflecting staff understanding of the term “adolescent,” and this was linked to 2 further themes, each of which had several subthemes. “Needs of the critically ill adolescent” included medical needs, dignity and privacy, issues around consent, and the impact of intensive care admission. “Implications for staff” included managing parental presence and lack of familiarity, and emotional impact, of dealing with this patient group. Some of these factors are currently better accommodated in adult settings. Conclusions: Decision-making about the place of care should take into account the individual circumstances of the patient (e.g., nature of their medical condition and previous experiences, maturity, family preference) and not be based only on age at admission. We should work across disciplines to ensure we can discover, and consistently deliver, best practice to meet the needs of critically ill adolescents.

scholarly journals Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alhassan Sibdow Abukari ◽  
Angela Kwartemaa Acheampong
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Teaching Hospitals ◽  
Critically Ill Children ◽  
Feeding Method ◽  
Tertiary Teaching ◽  
Critically Ill Child ◽  
Descriptive Qualitative

Abstract Background Critically ill children require optimum feeding in the intensive care units for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units. Methods A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N = 42). Results The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral, and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children. Conclusions Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU are recommended to reduce possible infant and child mortality resulting from suboptimal feeding.

scholarly journals Caring for critically ill adults in paediatric intensive care units in England during the COVID-19 pandemic: planning, implementation and lessons for the future

2021 ◽  
pp. archdischild-2020-320962
Author(s):  
Ruchi Sinha ◽  
Angela Aramburo ◽  
Akash Deep ◽  
Emma-Jane Bould ◽  
Hannah L Buckley ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Clinical Care ◽  
Adult Patients ◽  
Paediatric Intensive Care ◽  
Critically Ill Adults ◽  
Care Capacity ◽  
Ill Adults ◽  
Paediatric Intensive Care Units

ObjectiveTo describe the experience of paediatric intensive care units (PICUs) in England that repurposed their units, equipment and staff to care for critically ill adults during the first wave of the COVID-19 pandemic.DesignDescriptive study.SettingSeven PICUs in England.Main outcome measures(1) Modelling using historical Paediatric Intensive Care Audit Network data; (2) space, staff, equipment, clinical care, communication and governance considerations during repurposing of PICUs; (3) characteristics, interventions and outcomes of adults cared for in repurposed PICUs.ResultsSeven English PICUs, accounting for 137 beds, repurposed their space, staff and equipment to admit critically ill adults. Neighbouring PICUs increased their bed capacity to maintain overall bed numbers for children, which was informed by historical data modelling (median 280–307 PICU beds were required in England from March to June). A total of 145 adult patients (median age 50–62 years) were cared for in repurposed PICUs (1553 bed-days). The vast majority of patients had COVID-19 (109/145, 75%); the majority required invasive ventilation (91/109, 85%). Nearly, a third of patients (42/145, 29%) underwent a tracheostomy. Renal replacement therapy was provided in 20/145 (14%) patients. Twenty adults died in PICU (14%).ConclusionIn a rapid and unprecedented effort during the first wave of the COVID-19 pandemic, seven PICUs in England were repurposed to care for adult patients. The success of this effort was underpinned by extensive local preparation, close collaboration with adult intensivists and careful national planning to safeguard paediatric critical care capacity.

ICU admissions: Consequences after discharge

2020 ◽  
Vol 13 (9) ◽  
pp. 550-556
Author(s):  
Minal Karavadra ◽  
Ricky Bell
Keyword(s):  
Intensive Care ◽  
Cognitive Decline ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Psychiatric Disturbance ◽  
Intensive Care Department ◽  
Previous Level ◽  
The Uk

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.

scholarly journals Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

2020 ◽  
Vol 10 (4) ◽  
pp. 72
Author(s):  
Mohamed E. Abdelgawad ◽  
Nadia T. Ahmed ◽  
Ahmed M. Elmenshawy
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Improve Patient Care ◽  
University Hospital ◽  
Treatment Modalities ◽  
Control Group ◽  
Electrolyte Disturbances ◽  
Electrolyte Loss

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.

scholarly journals Kinetic Patterns of Candida albicans Germ Tube Antibody in Critically Ill Patients: Influence on Mortality

2009 ◽  
Vol 16 (10) ◽  
pp. 1527-1528 ◽  
Author(s):  
Rafael Zaragoza ◽  
Javier Pemán ◽  
Guillermo Quindós ◽  
Jose R. Iruretagoyena ◽  
María S. Cuétara ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Germ Tube ◽  
Antifungal Agents ◽  
Mortality Rates ◽  
Antifungal Treatment ◽  
Lower Mortality

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.

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