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icu admition priority

Y M Ye, F M Wang, C Jin, L L Zhou, D Q Chen
Objective: To investigate the hospital costs and related influencing factors in patients with acute poisoning. Methods: A retrospective analysis was performed for the general status and hospital costs of 373 patients with acute poisoning who were admitted to The Second Affiliated Hospital of Wenzhou Medical College from January 2009 to March 2015. The questionnaires were completed, the data were entered into Excel forms, and SPSS 18.0 was used to perform statistical analysis. Results: Among the 373 patients, 44...
July 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
Sean M Bagshaw, Dawn Opgenorth, Melissa Potestio, Stephanie E Hastings, Shelanne L Hepp, Elaine Gilfoyle, David McKinlay, Paul Boucher, Michael Meier, Jeanna Parsons-Leigh, R T Noel Gibney, David A Zygun, Henry T Stelfox
OBJECTIVES: Discrepancy in the supply-demand relationship for critical care services precipitates a strain on ICU capacity. Strain can lead to suboptimal quality of care and burnout among providers and contribute to inefficient health resource utilization. We engaged interprofessional healthcare providers to explore their perceptions of the sources, impact, and strategies to manage capacity strain. DESIGN: Qualitative study using a conventional thematic analysis...
September 15, 2016: Critical Care Medicine
Kelly M Shaffer, Eric Riklin, Jamie M Jacobs, Jonathan Rosand, Ana-Maria Vranceanu
OBJECTIVE: To assess the correlation of psychosocial resiliency factors (mindfulness and coping) with symptoms of posttraumatic stress, anxiety, and depression in patients recently admitted to the neuroscience ICU and their primary informal caregivers. DESIGN: A descriptive, cross-sectional correlational study. SETTING: Neuroscience ICU in a major medical center. PARTICIPANTS: A total of 78 dyads of patients (total n = 81) and their primary caregivers (total n = 92) from June to December 2015...
November 2016: Critical Care Medicine
Aaron C Spicer, Carolyn S Calfee, Matthew S Zinter, Robinder G Khemani, Victoria P Lo, Mustafa F Alkhouli, Benjamin E Orwoll, Ana L Graciano, Juan P Boriosi, James P Howard, Heidi R Flori, Michael A Matthay, Anil Sapru
OBJECTIVES: Despite declining mortality, acute respiratory distress syndrome is still involved in up to one third of pediatric intensive care deaths. The recently convened Pediatric Acute Lung Injury Consensus Conference has outlined research priorities for the field, which include the need for accurate bedside risk stratification of patients. We aimed to develop a simple yet robust model of mortality risk among pediatric patients with acute respiratory distress syndrome to facilitate the targeted application of high-risk investigational therapies and stratification for enrollment in clinical trials...
October 2016: Pediatric Critical Care Medicine
Vibeke Klastrup, Anne Mette Hvass, Julie Mackenhauer, Kurt Fuursted, Henrik Carl Schønheyder, Hans Kirkegaard
BACKGROUND: The search for the site of infection has high priority in patients with severe sepsis and septic shock. However, it is questionable whether mortality is associated with the specific site of infection in patients admitted to an intensive care unit (ICU). Therefore, the 30-day and 90-day mortalities in ICU patients admitted with suspected or confirmed community-acquired infection were studied. METHODS: A retrospective cohort study was conducted, including all adult patients admitted to a multi-specialty tertiary ICU with severe sepsis or septic shock from November 2008 to October 2010...
October 2016: Infectious Diseases
Joao Gabriel Rosa Ramos, Beatriz Perondi, Roger Daglius Dias, Leandro Costa Miranda, Claudio Cohen, Carlos Roberto Ribeiro Carvalho, Irineu Tadeu Velasco, Daniel Neves Forte
BACKGROUND: Intensive care unit (ICU) admission triage is performed routinely and is often based solely on clinical judgment, which could mask biases. A computerized algorithm to aid ICU triage decisions was developed to classify patients into the Society of Critical Care Medicine's prioritization system. In this study, we sought to evaluate the reliability and validity of this algorithm. METHODS: Nine senior physicians evaluated forty clinical vignettes based on real patients...
2016: Critical Care: the Official Journal of the Critical Care Forum
Burcu Bursal Duramaz, Hamdi Murat Yıldırım, Hasan Serdar Kıhtır, Osman Yeşilbaş, Esra Şevketoğlu
AIM: This study aimed to determine the epidemiological and clinical characteristics of pediatric forensic cases to contribute to the literature and to preventive health care services. MATERIAL AND METHODS: Pediatric forensic cases hospitalized in our pediatric intensive care unit below the age of 17 years were reviewed retrospectively (January 2009-June 2014) . The patients were evaluated in two groups as physical traumas (Group A) and poisonings (Group B). The patients' age, gender, complaints at presentation, time of presentation and referral (season, time) and, mortality rates were determined...
September 2015: Türk Pediatri Arşivi
Lavi Oud
BACKGROUND: Contemporary reporting of maternal mortality is focused on single, mutually exclusive causes of death among a minority of maternal decedents (pregnancy-related deaths), reflecting initial events leading to death. Although obstetric patients are susceptible to the lethal effects of downstream, more proximate contributors to death and to conditions not caused or precipitated by pregnancy, the burden of both categories and related patients' attributes is invisible to clinicians and healthcare policy makers with the current reporting system...
December 2015: Journal of Clinical Medicine Research
J R Paño-Pardo, C Schüffelmann-Gutiérrez, L Escosa-García, M Laplaza-González, F Moreno-Ramos, R Gómez-Gil, J D López, I Jordán, C Téllez, P de la Oliva
Improving antimicrobial use is a complex process that requires an accurate assessment of ongoing problems and barriers. Paediatric intensive care units (PICU) have seldom been assessed from this perspective. Two Internet-based, self-administered surveys were conducted nationwide in Spain between January and February 2014. The first survey aimed to assess those characteristics of Spanish PICUs that could influence antimicrobial prescribing or antimicrobial stewardship. The second survey targeted Spanish PICU physicians and pursued to assess their attitudes and perceptions regarding antimicrobial resistance and antimicrobial use...
February 2016: Clinical Microbiology and Infection
Hayley L Merkeley, Juliya Hemmett, Tara A Cessford, Neda Amiri, Georgia S Geller, Nazli Baradaran, Monica Norena, Hubert Wong, Najib Ayas, Peter M Dodek
PURPOSE: The purpose of the study is to reduce unnecessary ordering of routine-priority blood tests. METHODS: In this before-after study, we studied all patients admitted to a 15-bed tertiary intensive care unit (ICU) from July 1, 2011, to June 27, 2013. Based on input from intensivists, acceptable indications for ordering routine-priority complete blood counts (CBCs) and electrolyte/renal panels were developed. Sequential interventions were (1) education sessions for ICU housestaff about the lack of evidence for routine-priority blood tests; (2) an item on the ICU rounds checklist to ask if routine-priority blood tests were indicated; (3) a rubber stamp, "routine bloodwork NOT indicated for tomorrow," was used in the chart; (4) a prompt in the electronic ordering system to allow only accepted indications; and (5) a second educational session for ICU housestaff...
February 2016: Journal of Critical Care
Deborah Steiner, Fabienne Renetseder, Alexander Kutz, Sebastian Haubitz, Lukas Faessler, Janet Byron Anderson, Svenja Laukemann, Anna Christina Rast, Susan Felder, Antoinette Conca, Barbara Reutlinger, Marcus Batschwaroff, Petra Tobias, Ulrich Buergi, Beat Mueller, Philipp Schuetz
BACKGROUND: Accurate initial patient triage in the emergency department (ED) is pivotal in reducing time to effective treatment by the medical team and in expediting patient flow. The Manchester Triage System (MTS) is widely implemented for this purpose. Yet the overall effectiveness of its performance remains unclear. OBJECTIVES: We investigated the ability of MTS to accurately assess high treatment priority and to predict adverse clinical outcomes in a large unselected population of medical ED patients...
April 2016: Journal of Emergency Medicine
Markus Lang, Susan Waterworth, Anthony O'Brien
BACKGROUND: The world's leading cause of preventable deaths, diseases and disabilities is smoking. Hospitalization can provide an opportunity for smokers to quit. Previous research found that smokers make up a high percentage of patients admitted to intensive care. Health care professionals working in critical care environments can make a valuable contribution to this public health issue by providing smoking cessation advice. AIM: To identify factors that inhibit and facilitate the delivery of smoking cessation advice by nurses and doctors in critical care settings...
July 15, 2015: Nursing in Critical Care
Frode Lindemark, Øystein A Haaland, Reidar Kvåle, Hans Flaatten, Kjell A Johansson
BACKGROUND: Knowledge about the expected life years gained from intensive care unit (ICU) admission could inform priority-setting decisions across groups of ICU patients and across medical specialties. The aim of this study was to estimate expected remaining lifetime for patients admitted to ICUs during 2008-2010 and to estimate the gain in life years from ICU admission. METHODS: This is a descriptive, population modelling study of 30,712 adult mixed ICU admissions from the Norwegian Intensive Care Registry...
2015: PloS One
A Avila-Alvarez, R Carbajal, E Courtois, S Pertega-Diaz, J Muñiz-Garcia, K J S Anand
INTRODUCTION: Pain management and sedation is a priority in neonatal intensive care units. A study was designed with the aim of determining current clinical practice as regards sedation and analgesia in neonatal intensive care units in Spain, as well as to identify factors associated with the use of sedative and analgesic drugs. METHOD: A multicenter, observational, longitudinal and prospective study. RESULTS: Thirty neonatal units participated and included 468 neonates...
August 2015: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Karine S Kimak, Margarida M de Castro Antunes, Taciana D Braga, Katia G Brandt, Marilia de Carvalho Lima
OBJECTIVE: The aim of the present study was to investigate the influence of enteral feeding management on occurrences of necrotizing enterocolitis (NEC) in very-low-birth-weight (VLBW) infants. METHODS: This was a case-control study conducted in a sample of 1028 VLBW infants (750 to 1499 g) admitted to a neonatal intensive care unit between January 2003 and May 2008. "Cases" were infants born with VLBW and diagnosed with NEC within the first 30 days of life, and "controls" were VLBW infants who did not develop NEC during this period...
October 2015: Journal of Pediatric Gastroenterology and Nutrition
Mehmet Ali Aslaner, Meltem Akkaş, Sercan Eroğlu, Nalan M Aksu, Mehmet Mahir Özmen
INTRODUCTION: Many emergency departments (EDs) have established units capable of providing critical care because of increasing need for critical care, called as ED intensive care unit (EDICU). However, prolonged critical care leads to crowding, resulting in poor quality of care and high mortality rates. We aimed to determine which type of critically ill patients play a main role for crowding in the EDICU, and how to manage these patients. METHOD: Patients aged older than 18 years who presented to the ED and presented for consultation to the ICU were eligible for inclusion in this study...
April 2015: American Journal of Emergency Medicine
Johane P Allard, Heather Keller, Khursheed N Jeejeebhoy, Manon Laporte, Don R Duerksen, Leah Gramlich, Helene Payette, Paule Bernier, Elisabeth Vesnaver, Bridget Davidson, Anastasia Teterina, Wendy Lou
BACKGROUND: In hospitals, length of stay (LOS) is a priority but it may be prolonged by malnutrition. This study seeks to determine the contributors to malnutrition at admission and evaluate its effect on LOS. MATERIALS AND METHODS: This is a prospective cohort study conducted in 18 Canadian hospitals from July 2010 to February 2013 in patients ≥ 18 years admitted for ≥ 2 days. Excluded were those admitted directly to the intensive care unit; obstetric, psychiatry, or palliative wards; or medical day units...
May 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Manish Sadarangani, David W Scheifele, Scott A Halperin, Wendy Vaudry, Nicole Le Saux, Raymond Tsang, Julie A Bettinger
BACKGROUND: Neisseria meningitidis causes 500 000 cases of septicemia and meningitis worldwide annually, with approximately 200 cases in Canada each year. Previous studies describe a case-fatality rate of 5%-15% and up to 20% of survivors suffering from long-term disability. METHODS: This study was performed in Canada between 2002 and 2011; the study area included >50% of the country's population. We identified risk factors associated with death and the development of complications in children and adults admitted to hospital with confirmed invasive meningococcal disease (IMD)...
April 15, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
F Casas Maldonado, I Alfageme Michavila, V S Barchilón Cohen, J I Peis Redondo, D A Vargas Ortega
Community-acquired pneumonia is an acute respiratory infectious disease which has an incidence of 3-8 cases/1,000 inhabitants, and increases with age and comorbidities. The pneumococcus is the organism most frequently involved in community-acquired pneumonia in the adult (30-35%). Around 40% of patients with community-acquired pneumonia require hospital admission, and around 10% need to be admitted to an intensive care unit. The most serious forms of pneumococcal infection include invasive pneumococcal disease (IPD), which covers cases of bacteremia (associated or not to pneumonia), meningitis, pleuritis, arthritis, primary peritonitis and pericarditis...
September 2014: Semergen
Charles St-Arnaud, Jean-François Ethier, Cindy Hamielec, Andrew Bersten, Gordon Guyatt, Maureen Meade, Qi Zhou, Marc-André Leclair, Alpesh Patel, François Lamontagne
BACKGROUND: Without robust clinical evidence to guide titration of vasopressors in septic shock, it is unclear how dosing of these potent medications occurs. We sought to measure the proportion of vasopressor prescriptions for septic shock that were missing explicit targets and to describe the targets that we identified. METHODS: We conducted a multicentre, retrospective cohort study involving 9 intensive care units (ICUs) located at 3 academic hospitals in Canada and Australia...
October 2013: CMAJ Open
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