scholarly journals Electrolytes in the ICU

2021 ◽  
Author(s):  
Syed Zaidi ◽  
Rahul Bollam ◽  
Kainat Saleem
Keyword(s):  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Healthcare Providers ◽  
Electrolyte Disorders ◽  
Sodium Potassium ◽  
Sodium Homeostasis ◽  
Neurologic Symptoms ◽  
Calcium Bicarbonate ◽  
Cardiac Manifestations

Electrolyte disorders is an imbalance of certain ionized salts (sodium, potassium, calcium, bicarbonate, chloride) in the blood. Healthcare providers should be familiar with the principles of electrolyte physiology and pathophysiology. Disturbances in sodium homeostasis are primarily caused by volume abnormalities leading to primarily neurologic symptoms. Dyskalemias frequently present with cardiac manifestations therefore should be treated promptly before evaluating its cause. Ion deficiencies such as hypocalcemia, hypomagnesemia and hypophosphatemia should be corrected as they are associated with increased adverse events in critically ill patients.

Implementation of a pet visitation program in critical care

1999 ◽  
Vol 19 (3) ◽  
pp. 43-50 ◽  
Author(s):  
KK Giuliano ◽  
E Bloniasz ◽  
J Bell
Keyword(s):  
Critically Ill ◽  
Emotional Support ◽  
Critically Ill Patients ◽  
Quantitative Research ◽  
Therapeutic Option ◽  
Healthcare Providers ◽  
Research Data ◽  
Staff Members ◽  
Common Problems ◽  
Patients Experience

We have no quantitative research data to document that these visits are actually helpful to patients in any measurable way, although we certainly hope to have some soon. However, observations of staff members and evaluations from participants in the program have been quite positive thus far. The program has been in place for more than 2 years, and about 30 pets have visited so far, including 28 dogs and 2 cats. Implementing a pet visitation program for critically ill patients affords healthcare providers the opportunity to offer a unique and humanistic therapeutic intervention to appropriate patients. Although it is a time-consuming endeavor, it has been well received by those patients and families that have participated in pet visits. Critically ill patients are often denied many simple pleasures because they are in physiological crisis. Such patients experience loneliness, isolation, depression, and lack of emotional support. Pet visitation is one way to address these common problems of ICU patients. For this reason, pet visitation will remain a therapeutic option for the support of our critically ill patients.

scholarly journals Identifying the effects of an upgraded ‘fever clinic’ on COVID-19 control and the workload of emergency department: retrospective study in a tertiary hospital in China

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039177
Author(s):  
Jiangshan Wang ◽  
Liang Zong ◽  
Jinghong Zhang ◽  
Han Sun ◽  
Joseph Harold Walline ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Disease Transmission ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
College Hospital ◽  
Upper Respiratory Infection ◽  
Number Of Patients ◽  
Screening And Prevention

ObjectiveCOVID-19 started spreading widely in China in January 2020. Outpatient fever clinics (FCs), instituted during the SARS epidemic in 2003, were upgraded to serve for COVID-19 screening and prevention of disease transmission in large tertiary hospitals in China. FCs were hoped to relieve some of the healthcare burden from emergency departments (EDs). We aimed to evaluate the effect of upgrading the FC system on rates of nosocomial COVID-19 infection and ED patient attendance at Peking Union Medical College Hospital (PUMCH).DesignA retrospective cohort study.ParticipantsA total of 6365 patients were screened in the FC.MethodsThe FC of PUMCH was upgraded on 20 January 2020. We performed a retrospective study of patients presenting to the FC between 12 December 2019 and 29 February 2020. The date when COVID-19 was declared an outbreak in Beijing was 20 January 2020. Two groups of data were collected and subsequently compared with each other: the first group of data was collected within 40 days before 20 January 2020; the second group of data was collected within 40 days after 20 January 2020. All necessary data, including patient baseline information, diagnosis, follow-up conditions and the transfer records between the FC and ED, were collected and analysed.Results6365 patients were screened in the FC, among whom 2912 patients were screened before 21 January 2020, while 3453 were screened afterward. Screening results showed that upper respiratory infection was the major disease associated with fever. After the outbreak of COVID-19, the number of patients who were transferred from the FC to the ED decreased significantly (39.21% vs 15.75%, p<0.001), and patients generally spent more time in the FC (55 vs 203 min, p<0.001), compared with before the outbreak. For critically ill patients waiting for their screening results, the total length of stay in the FC was 22 min before the outbreak, compared with 442 min after the outbreak (p<0.001). The number of in-hospital deaths of critically ill patients in the FC was 9 out of 29 patients before the outbreak and 21 out of 38 after the outbreak (p<0.05). Nineteen cases of COVID-19 were confirmed in the FC during the period of this study. However, no other patients nor any healthcare providers were cross-infected.ConclusionThe workload of the FC increased significantly after the COVID-19 outbreak. New protocols regarding the use of FC likely helped prevent the spread of COVID-19 within the hospital. The upgraded FC also reduced the burden on the ED.

Adverse Events Among Hospitalized Critically Ill Patients

Medical Care ◽  
2020 ◽  
Vol 58 (1) ◽  
pp. 38-44
Author(s):  
Khara M. Sauro ◽  
Andrea Soo ◽  
Hude Quan ◽  
Henry T. Stelfox
Keyword(s):  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients

Moderate adverse events during intrahospital transportation prolong length of stay of critically ill patients

2017 ◽  
Vol 42 ◽  
pp. 398
Author(s):  
Debora Carvalho Grion ◽  
Francielli Mary Pereira Gimenez ◽  
Igor Veiga Silverio ◽  
Isabela Faria Larini ◽  
Marianne Machado ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients

Safety Matters: A Meta-analysis of Interhospital Transport Adverse Events in Critically Ill Patients

2021 ◽  
Author(s):  
Maniraj Jeyaraju ◽  
Sanketh Andhavarapu ◽  
Jamie Palmer ◽  
Vera Bzhilyanskaya ◽  
Eric Friedman ◽  
...  
Keyword(s):  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Interhospital Transport

scholarly journals Incidence and predictors of adverse events and outcomes for adult critically ill patients transferred by paramedics to a tertiary care medical facility

2017 ◽  
Vol 5 (4) ◽  
pp. 206
Author(s):  
Abdullah Alabdali ◽  
Chetan Trivedy ◽  
Nawfal Aljerian ◽  
PeterK Kimani ◽  
Richard Lilford
Keyword(s):  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Medical Facility

scholarly journals The impact of a bundled intrahospital transfer protocol on the safety of critically ill patients in a South African Metropolitan Hospital System

2020 ◽  
pp. 139-148
Author(s):  
L Geldenhuys ◽  
R Wise ◽  
R Rodseth
Keyword(s):  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Hospital ◽  
Composite Outcome ◽  
Post Intervention ◽  
Hospital System ◽  
Metropolitan Hospital ◽  
Event Rates ◽  
The Impact

Background: Intrahospital transfer (IHT) of critically ill patients is associated with a high incidence of adverse events (AEs). This study aimed to determine whether the introduction of an intervention bundle could decrease AEs during, and immediately after IHT to the intensive care unit (ICU), as compared to event rates prior to the bundle’s introduction. Methods: This was a prospective, pre- and post-intervention trial, conducted in both a regional and tertiary hospital in Pietermaritzburg, South Africa. The intervention bundle consisted of an IHT protocol, a transport backpack, emergency drug container and simulation training. Primary outcomes were: 1) composite outcome of serious AEs, and 2) composite outcome of AEs contributing directly to morbidity or mortality. Secondary outcomes were miscellaneous complications, equipment-related AEs, total number of AEs, total number of IHTs complicated by AEs and the subjective measure of IHTs needing intervention within the first 30 minutes after arrival in ICU. Results: There were 381 pre-intervention IHTs and 264 post-intervention IHTs with one documented serious AE. Adverse events directly contributing to morbidity or mortality showed a reduction from 58.3% (CI 0.53–0.63) pre-intervention, to 56.1% (CI 0.50–0.62) post-intervention (p = 0.6). Miscellaneous complications yielded a reduction of 12.9% (CI 10.3–14.7%) pre-intervention to 9.5% (CI 8.3–11.1%) post-intervention (p = 0.2). Equipment-related AE reduced from 5.2% (CI 3.4–8%) to 1.9% (CI 0.8–4.5%) (p = 0.03). The total number of AEs reduced from 5% (CI 3.6–7.4%) to 4.1% (CI 2.4–6.8%) (p = 0.03), while the total number of transfers complicated by AEs reduced from 63.3% (CI 61.9–65.1%) to 60.6% (CI 58.8–63.1%) (p = 0.5). There was a reduction in IHTs requiring intervention within the first 30 minutes of arrival in ICU (34.6% to 22.7%; p = 0.001). Conclusion: These results support the use of an intervention bundle to decrease the incidence of AEs during IHT.

Managing Adverse Events

2016 ◽  
Author(s):  
Sven Staender
Keyword(s):  
Adverse Event ◽  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Severe Complication ◽  
Technical Expertise

The focus of anesthesiologists’ training and activities concerns the management of critically ill patients and the avoidance of catastrophe, rather than management of the aftermath. Anesthesiologists spend years acquiring technical expertise, and there are checklists for dealing with complications. Anesthesiologists have accumulated an immense knowledge in physiology, pathophysiology, and pharmacology, but there is little understanding of how to deal with the overwhelming emotions that occur after a severe complication or adverse event. Death or severe harm to a patient under an anesthesiologist’s care may be rare, but can significantly impact a professional’s ability to care for patients and may also affect his or her life outside the hospital.

In-hospital transfer of the critically ill

2016 ◽  
Author(s):  
Lorna Eyre ◽  
Simon Whiteley
Keyword(s):  
Adverse Events ◽  
Critically Ill ◽  
Vascular Access ◽  
Critically Ill Patients ◽  
Morbidity And Mortality ◽  
Critically Ill Patient ◽  
Vascular Access Devices ◽  
Endotracheal Tubes ◽  
High Incidence ◽  
Hospital Transfer

While focus has traditionally been on the planning, logistics, and outcome of inter-hospital transfers of the critically-ill patient, attention is turning to in-hospital transfers. Numerically, more in-hospital transfers occur and there is growing evidence that these are associated with a high incidence of adverse events, and increased morbidity and mortality. Appropriate planning, communication, and preparation are essential. Patients should be resuscitated and stabilized (optimized) prior to transfer, to prevent deterioration or instability during transfer. Endotracheal tubes and vascular access devices should be secure. The minimum recommended standards of monitoring should be applied. All drugs and equipment likely to be required during the transfer should be checked and available. Critically-ill patients should be accompanied by personnel with the appropriate knowledge skills and experience to carry out the transfer safely and to deal with any complications or incidents that arise.

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