scholarly journals Challenges Faced by the Intensive Care Unit during a Terrorist Attack: The Riyadh Experience

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Abdullah Al-Shimemeri
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
News Media ◽  
Terrorist Attack ◽  
Terrorist Attacks ◽  
Terror Attacks ◽  
Health Institutions ◽  
Improvised Explosive ◽  
Explosive Devices ◽  
The City

Background. Globally, we are facing a “terror epidemic” with incidences of terrorist attacks on innocent civilians increasing worldwide. The volume and nature of injuries resulting from such attacks challenge even the most sophisticated and well-prepared trauma systems and health institutions. Over seventy percent of terror attacks involve bomb explosions with improvised explosive devices (IEDs) resulting in a unique pattern of injuries to the victims. Here, we present data on the terrorist attacks on the city of Riyadh, Saudi Arabia, between March 1991 to the present and discuss in retrospect the event outcomes and features which may be useful for the preparedness of the intensive care unit (ICU) in the wake of future attacks. Methods. Data from nine hospitals in Riyadh that catered to patients during terrorist strikes were collected retrospectively. Details of the incidents were collected from news media archives. Results. The majority of terror strikes (~80%) involved a bomb blast with the use of explosives. The victims included 148 casualties, 45 hospitalizations, 103 discharges after first aid, and 3 incidences of admission to the critical care unit. Conclusion. Using the Riyadh experience, we analyze data and the series of events in the ICU following terrorist explosions. The analysis provides important insights for the trauma unit so that it is better prepared and organized for such incidents in the future.

Terrorists Use of Ambulances for Terror Attacks: A Review

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Gregory N. Jasani ◽  
Reem Alfalasi ◽  
Garrett A. Cavaliere ◽  
Gregory R. Ciottone ◽  
Benjamin J. Lawner
Keyword(s):  
Terrorist Attack ◽  
Study Objective ◽  
Terrorist Organizations ◽  
Loss Of Life ◽  
Event Time ◽  
Terror Attacks ◽  
Improvised Explosive ◽  
Explosive Devices ◽  
Global Terrorism Database ◽  
Health Experts

Abstract Introduction: Using an ambulance as an attack modality offers many advantages to a terrorist organization. Ambulances can carry more explosives than most vehicles and can often bypass security. Yet, studies examining how terrorist organizations have incorporated ambulances into their attacks are lacking. Study Objective: This article seeks to identify and analyze known instances in which an ambulance has been used in a terrorist attack. Methods: The Global Terrorism Database (GTD) was searched for terrorist events that involved the use of an ambulance from the years 1970-2018. Variables of event time, location, and loss of life were analyzed. Results: Twenty instances where an ambulance had been used in a terrorist attack were identified from the GTD. Fifteen of the attacks occurred in the Middle East, while the remaining five occurred in Southeast Asia. All attacks except one had occurred after 2001, and 13 had occurred within the past decade. Most attacks (12/20) resulted in up to three people killed, while six attacks had 10-20 casualties. The deadliest attack occurred in Kabul, Afghanistan in 2018 and caused over 100 casualties. One event did not have casualty information in the GTD. In all cases, ambulances were used as vehicle-borne improvised explosive devices (VBIED) by terrorist organizations. Conclusion: This study shows that terrorists are increasingly acquiring and utilizing ambulances in their attacks, often with deadly consequences. Security and public health experts must be aware of this hazard and work to deny terrorists access to these vehicles.

scholarly journals Emergence of Candida auris in Brazil in a COVID-19 Intensive Care Unit

2021 ◽  
Vol 7 (3) ◽  
pp. 220
Author(s):  
João N. de Almeida ◽  
Elaine C. Francisco ◽  
Ferry Hagen ◽  
Igor Brandão ◽  
Felicidade M. Pereira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antifungal Susceptibility ◽  
Candida Auris ◽  
Minimal Inhibitory Concentrations ◽  
First Case ◽  
Asian Clade ◽  
Travel Restrictions ◽  
Clade C ◽  
The City

In December 2020, Candida auris emerged in Brazil in the city of Salvador. The first two C. auris colonized patients were in the same COVID-19 intensive care unit. Antifungal susceptibility testing showed low minimal inhibitory concentrations of 1 µg/mL, 2 µg/mL, 0.03 µg/L, and 0.06 µg/mL for amphotericin B, fluconazole, voriconazole, and anidulafungin, respectively. Microsatellite typing revealed that the strains are clonal and belong to the South Asian clade C. auris. The travel restrictions during the COVID-19 pandemic and the absence of travel history among the colonized patients lead to the hypothesis that this species was introduced several months before the recognition of the first case and/or emerged locally in the coastline Salvador area.

scholarly journals The role of the nurse in the neonatal intensive care unit: between the ideal, the real and the possible

2011 ◽  
Vol 19 (2) ◽  
pp. 301-308 ◽  
Author(s):  
Liciane Langona Montanholi ◽  
Miriam Aparecida Barbosa Merighi ◽  
Maria Cristina Pinto de Jesus
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Public And Private ◽  
Public And Private Hospitals ◽  
The City ◽  
Social Phenomenology ◽  
The Ideal

The nurse is one of the professionals responsible for the care directed toward the physical, mental and social development of newborns in the Neonatal Intensive Care Unit. This study aimed to comprehend the experience of nurses working in a Neonatal Intensive Care Unit. Data collection was performed in 2008, through interviews with 12 nurses working in public and private hospitals of the city of São Paulo. The units of meaning identified were grouped into three categories: Developing actions; Perceiving their actions and Expectations. The analysis was based on social phenomenology. It was concluded that the overload of activities, the reduced number of staff, the lack of materials, equipment and the need for professional improvement are the reality of the work of the nurse in this sector. To supervise the care is the possible; integral care of the newborn, involving the parents, is the ideal desired.

scholarly journals Billing of nursing procedures at an intensive care unit

2011 ◽  
Vol 19 (3) ◽  
pp. 573-580 ◽  
Author(s):  
Raquel Silva Bicalho Zunta ◽  
Valéria Castilho
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Private Hospital ◽  
Quantitative Approach ◽  
Essential Information ◽  
Nursing Managers ◽  
Important Argument ◽  
The City ◽  
Hospital Revenues ◽  
Safe Care

This study aimed to: estimate the billing of nursing procedures at an intensive care unit and calculate how much of total ICU revenues are generated by nursing. An exploratory-descriptive, documentary research with a quantitative approach was carried out. The study was performed at a general ICU of a private hospital in the city of Sao Paulo. The sample consisted of 159 patients. It was concluded that the nursing procedures were responsible for 15.1% of total ICU revenues, which breaks down to an average 11.3% of revenues coming from nursing prescriptions and 3.8% from medical prescriptions. Demonstrating how much nursing contributes to hospital revenues is essential information for nursing managers, as it is an important argument to obtain resources and guarantee safe care.

Markov models to detect the deterioration of patients in a pediatric intensive care unit: analytical observational study Ledys M. Izquierdo MD, MSc, Luis F. Niño PhD Jhon S. Rojas (Preprint)

2021 ◽  
Author(s):  
Ledys Izquierdo
Keyword(s):  
Data Mining ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Confusion Matrix ◽  
Pediatric Intensive Care ◽  
Warning Signs ◽  
Classification Model ◽  
Military Hospital ◽  
The City

BACKGROUND In the field of continuous vital-sign monitoring in critical care settings, it has been observed that the “early-warning signs” of impending physiological deterioration can fail to be detected timely and sometimes by resource constrained clinical staff. OBJECTIVE to develop a probabilistic model to detect the deterioration of patients in a pediatric intensive care unit. METHODS cross-sectional cohort study, pediatric intensive care unit of the Central Military Hospital in the city of Bogota, Colombia. Children from 1 to 18 years old from January 2018 to January 2020. The CRISP-DM (CRoss-Industry Standard Process for Data Mining) methodology was used as a data mining process and then we used Markov chains to identify the clinical states through which the patient passes. Then, a Hidden Markov model (HMM) based approach is applied for classification and prediction of patient's deterioration by computing the probability of future clinical states. RESULTS Both learning models were trained and evaluated using six vital signs data from 94,678 patient records, collected from the database of real patients who were in the Pediatric Intensive Care Unit of the Central Military Hospital in the city of Bogota, Colombia. To obtain the HMM based classification model, 10-fold cross validation was performed. the confusion matrix showed, Accuracy :0,7, precision: 0.75 and the F1 score:0.65. CONCLUSIONS classification analysis in medical applications can be very useful if considered as a very significant support tool for health professionals. CLINICALTRIAL does not apply

scholarly journals Level of acuity, severity and intensity of care of adults and older adults admitted to the Intensive Care Unit

2019 ◽  
Vol 53 ◽  
Author(s):  
Renata Eloah de Lucena Ferretti-Rebustini ◽  
Nilmar da Silva Bispo ◽  
Winnie da Silva Alves ◽  
Thiago Negreiro Dias ◽  
Cristiane Moretto Santoro ◽  
...  
Keyword(s):  
Older Adults ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Group Method ◽  
Predictive Capacity ◽  
Organic Dysfunction ◽  
Intensity Of Care ◽  
Correlation Tests ◽  
The City

ABSTRACT Objective: To characterize the level of acuity, severity and intensity of care of adults and older adults admitted to Intensive Care Units and to identify the predictors of severity with their respective predictive capacity according to the age group. Method: A retrospective cohort based on the analysis of medical records of individuals admitted to eight adult intensive care units in the city of São Paulo. The clinical characteristics at admission in relation to severity profile and intensity of care were analyzed through association and correlation tests. The predictors were identified by linear regression and the predictive capacity through the ROC curve. Results: Of the 781 cases (41.1% from older adults), 56.2% were males with a mean age of 54.1 ± 17.3 years. The burden of the disease, the organic dysfunction and the number of devices were the predictors associated with greater severity among adults and older adults, in which the organic dysfunction had the highest predictive capacity (80%) in both groups. Conclusion: Adults and older adults presented a similar profile of severity and intensity of care in admission to the Intensive Care Unit. Organic dysfunction was the factor with the best ability to predict severity in adults and older adults.

State-of-the-Art Review on Anti-Ram Bollards

2011 ◽  
Vol 90-93 ◽  
pp. 3206-3213 ◽  
Author(s):  
Bo Hu ◽  
Guo Qiang Li ◽  
Su Wen Chen ◽  
Wen Long Shi
Keyword(s):  
Design Theory ◽  
State Of The Art ◽  
Terrorist Attacks ◽  
Crash Test ◽  
Improvised Explosive Devices ◽  
First Line ◽  
Certification Standard ◽  
History Of ◽  
Improvised Explosive ◽  
Explosive Devices

Perimeter protection is an important physical protection approach for buildings and infrastructures, which is also regarded as the first line of protection. Vehicle borne improvised explosive devices (VBIED) have been recognized as a major design threat by many government agencies for years, since they have been so extensively used in past terrorist attacks against critical buildings and infrastructures. Preventing unauthorized vehicles from approaching a protected area with vehicle barriers installed in perimeter of the buildings and infrastructures would consequently reduce blast and debris threats. The history of test certification standard for vehicle barriers is briefly reviewed. The research achievements on anti-ram bollards, one type of vehicle barriers, in the fields of crash test, numerical simulation, and design theory are presented. The remaining problems and deficiencies of the research are pointed out and the corresponding proposals are put forward. Finally, some further research works on anti-ram bollards are proposed.

scholarly journals Conversion of a maternity hospital to an infectious diseases hospital in the context of a coronavirus infection pandemic

2021 ◽  
Vol 2 (1) ◽  
pp. 36-40
Author(s):  
Sergey N. Perehodov ◽  
Nikoloz Yu. Sakvarelidze ◽  
Svetlana G. Tsakhilova ◽  
Elena V. Lunina
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infectious Diseases ◽  
Russian Federation ◽  
Maternity Hospital ◽  
Medical Institutions ◽  
Coronavirus Infection ◽  
The Russian Federation ◽  
The Government ◽  
The City

Coronavirus infection caused by a new strain of SARS-CoV-2 virus contributed to an increase in the number of infectious patients. The Ministry of Health of the Russian Federation and Rospotrebnadzor took over the organization of work to combat the pandemic. In Moscow, medical and preventive events were organized by the Government of the capital and the Department of Health of the city. As soon as possible, it was decided to reassign medical institutions to infectious hospitals for the treatment of patients with COVID-19 or with suspicion of it. “Maternity hospital No. 8” – the branch of State Clinical Hospital named after V. P. Demikhov was redesigned as a hospital on March 13, 2020. The decision was due to the presence of isolated boxes and an intensive care unit in the institution. The task was solved in one day: the first patients with coronavirus infection were admitted to the hospital for medical care at 17:00 on March 13, 2020.

scholarly journals TRAQUEOSTOMÍA TEMPRANA VS TARDÍA EN PACIENTES NEUROQUIRÚRGICOS INTERNADOS EN UNA UNIDAD DE CUIDADOS INTENSIVOS.

2020 ◽  
Vol 5 (4) ◽  
pp. 12
Author(s):  
Freiser Eceomo Cruz Mosquera ◽  
Nathaly Erazo Builes ◽  
Juan Camilo Angulo Cano ◽  
María Paula Solarte-Roa ◽  
Daniel Mauricio Muñoz Piamba ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Statistical Analysis ◽  
Intensive Care Units ◽  
Total Sample ◽  
Early Tracheostomy ◽  
Neurosurgical Patients ◽  
Clinical Benefits ◽  
The City

Introducción: Los pacientes neurocríticos por lo general requieren periodos largos de ventilación mecánica, en ese contexto la traqueostomía es un procedimiento frecuente que se realiza para facilitar el destete de la ventilación y se asocia a múltiples beneficios; sin embargo, el momento de su realización sigue siendo objeto de debate. Objetivo: determinar los beneficios clínicos   de la traqueostomía temprana vs la tardía en los pacientes neurocríticos que ingresan a una unidad de cuidados intensivos (UCI) polivalente de una institución de salud de la ciudad de Cali. Metodología: investigación observacional, descriptiva, de serie de casos que incluyó pacientes neuroquirúrgicos, mayores de edad que ingresaron a una UCI durante el periodo 2016 -2018; a partir de la muestra total se estipularon dos grupos: traqueostomía temprana (≤ 9 días) y traqueostomía tardía (≥10 días).  El análisis estadístico se realizó en el programa SPSS versión 24. Resultados: Se incluyeron 20 sujetos con edad de 51.9±17 años, 10 fueron asignados al grupo de traqueostomía temprana y 10 al grupo den traqueostomía tardía. Se evidenció que los pacientes con traqueostomía temprana tienen menos días de sedación (10±2.1 vs 16±9; p=0.02) y los 3 casos que fallecieron habían sido traqueostomizados tardíamente. Conclusiones: La traqueostomía temprana puede traer beneficios clínicos a los pacientes neuroquirúrgicos que ingresan a unidades de cuidados intensivos.                                                                                                                   Palabras claves: Traqueostomía, unidades de cuidados intensivos, paciente, ventilación mecánica. ABSTRACT Introduction: Neurocritical patients generally require long periods of mechanical ventilation. In this context, tracheostomy is a frequent procedure performed to facilitate weaning from ventilation and is associated with multiple benefits; however, the timing of its implementation remains under debate. Objective: to determine the clinical benefits of early vs late tracheostomy in neurocritical patients admitted to a polyvalent intensive care unit (ICU) of a health institution in the city of Cali. Methodology: observational, descriptive investigation of a series of cases that included neurosurgical patients, of legal age who were admitted to an ICU during the period 2016 -2018; From the total sample, two groups were stipulated: early tracheostomy (≤ 9 days) and late tracheostomy (≥10 days). Statistical analysis was performed using SPSS version 24. Results: 20 subjects with an age of 51.9 ± 17 years were included, 10 were assigned to the early tracheostomy group and 10 to the late tracheostomy group. It was evidenced that patients with early tracheostomy had fewer days of sedation (10±2.1 vs 16± 9; p= 0.02) and the 3 cases that died had been tracheostomized late. Conclusions: Early tracheostomy can bring clinical benefits to neurosurgical patients admitted to intensive care units. Keywords: Tracheostomy, intensive care units, patient, mechanic ventilation.

scholarly journals Direito à saúde e Unidades de Tratamento Intensivo Neonatal (UTINs): uma breve reflexão sobre a eficácia das decisões judiciais no Estado do Maranhão

2017 ◽  
Vol 18 (2) ◽  
pp. 525-544
Author(s):  
Edith Maria Barbosa Ramos ◽  
Lidia Cunha Schramm de Sousa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Public Management ◽  
Neonatal Intensive Care ◽  
Descriptive Study ◽  
Health Policies ◽  
Public Health Policies ◽  
Childhood And Youth ◽  
The City

Resumo: A judicialização das políticas públicas de saúde é um fenômeno crescente em todo o País, tendo diversos âmbitos do Poder Judiciário recebido demandas relacionadas à saúde, no entanto, percebe-se que essa discussão tem reflexos nos três Poderes. O presente artigo teve por escopo compreender o sistema normativo que regulamenta o acesso a leitos de Unidades de Tratamento Intensivo Neonatal (UTINs), bem como analisar a eficácia das decisões judiciais no Maranhão, com foco nas decisões de magistrados da 1ª Vara da Infância e Juventude da comarca de São Luís, MA. Realizou-se um estudo descritivo e exploratório, com levantamento bibliográfico e documental, notadamente, em documentos disponibilizados nos sites do Poder Judiciário maranhense, do Ministério da Saúde, Secretaria de Saúde do Estado do Maranhão e do Município de São Luís. Ao fim, foram feitas algumas considerações sobre a problemática da judicialização da saúde como fenômeno que expõe as fragilidades e as descontinuidades das ações desenvolvidas pelas casas legislativas, pela gestão pública e pelo próprio sistema de justiça.Palavras-chave: Direito à saúde. Unidade de tratamento intensivo. Poder Judiciário. Abstract: The legalization of public health policies is a growing phenomenon throughout the country, having many areas of the Judiciary received demands related to health, however, it is clear that this discussion is reflected in the three Branches. This article had the scope to understand the legal system that regulates access to the Neonatal Intensive Care Unit beds (NICUs) and to analyze the effectiveness of judgments in Maranhão, focusing on judges decisions of the 1st Court of Childhood and Youth of the district of São Luís, MA. We conducted a descriptive study, with bibliographic and documental survey, notably in documents available on the websites of the judiciary of Maranhão, the Ministry of Health, Health Secretariat of the State of Maranhão, and the City of São Luís. In the end, some considerations were made about the problem of the judicialisation of health as a phenomenon that exposes the weakness and discontinuity of the actions developed by legislative bodies, public management and own justice system.Keywords: Right to health. Neonatal Intensive Care Unit. Judicial Branch.

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