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Intensive Care REPACK

An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensive care medicine.

Intensive Care

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Intensive care units cater to patients with severe or life-threatening illnesses and injuries, which require constant care, close supervision from life support equipment and medication in order to ensure normal bodily functions. They are staffed by highly trained physicians, nurses and respiratory therapists who specialize in caring for critically ill patients. ICUs are also distinguished from general hospital wards by a higher staff-to-patient ratio and access to advanced medical resources and equipment that is not routinely available elsewhere. Common conditions that are treated within ICUs include respiratory and cardiovascular , as well as neurology .

In 1950, anesthesiologist Peter Safar established the concept of advanced life support, keeping patients sedated and ventilated in an intensive care environment. Safar is considered to be the first practitioner of intensive care medicine as a speciality.

The available data suggests a relation between ICU volume and quality of care for mechanically ventilated patients.[7] After adjustment for severity of illnesses, demographic variables, and characteristics of different ICUs (including staffing by intensivists), higher ICU staffing was significantly associated with lower ICU and hospital mortality rates. A ratio of 2 patients to 1 nurse is recommended for a medical ICU, which contrasts to the ratio of 4:1 or 5:1 typically seen on medical floors. This varies from country to country, though; e.g., in Australia and the United Kingdom, most ICUs are staffed on a 2:1 basis (for high-dependency patients who require closer monitoring or more intensive treatment than a hospital ward can offer) or on a 1:1 basis for patients requiring extreme intensive support and monitoring; for example, a patient on a mechanical ventilator with associated anaesthetics or sedation such as propofol, midazolam and use of strong analgesics such as morphine, fentanyl and/or remifentanil.

In the United States, up to 20% of hospital beds can be labelled as intensive-care beds; in the United Kingdom, intensive care usually will comprise only up to 2% of total beds. This high disparity is attributed to admission of patients in the UK only when considered the most severely ill.[9]

Intensive care is an expensive healthcare service. A recent study conducted in the United States found that hospital stays involving ICU services were 2.5 times more costly than other hospital stays.[10]

Some hospitals have installed teleconferencing systems that allow doctors and nurses at a central facility (either in the same building, at a central location serving several local hospitals, or in rural locations another more urban facility) to collaborate with on-site staff and speak with patients (a form of telemedicine). This is variously called an eICU, virtual ICU, or tele-ICU. Remote staff typically have access to vital signs from live monitoring systems, and telectronic health records so they may have access to a broader view of a patient's medical history. Often bedside and remote staff have met in person and may rotate responsibilities. Such systems are beneficial to intensive care units in order to ensure correct procedures are being followed for patients vulnerable to deterioration, to access vital signs remotely in order to keep patients that would have to be transferred to a larger facility if need be he/she may have demonstrated a significant decrease in stability.[12][13][14][15]

"Intensive Care Medicine" is the publication platform for the communication and exchange of current work and ideas in intensive care medicine. It is intended for all those who are involved in intensive medical care, physicians, anaesthetists, surgeons, pediatricians, as well as those concerned with pre-clinical subjects and medical sciences basic to these disciplines.

The journal publishes: review articles reflecting the present state of knowledge in special areas or summarizing limited themes in which discussion has led to clearly defined conclusions; original papers reporting progress and results in all areas of intensive care medicine and its related fields; educational articles giving information on the progress of a topic of particular interest; discussion on technology, methods, new apparatus and modifications of standard techniques; brief reports of uncommon and interesting disorders; correspondence concerning matters of topical interest or relating to published material; and book reviews, reports of meetings, and announcements

Post-intensive care syndrome (PICS) describes the disability that remains in the surviving the critical illness. This comprises of impairment in cognition, psychological health, and physical function of the intensive care unit (ICU) survivor.[1, 2] Consequent to this, the psychological health of family members of the survivor may also be affected in an adverse manner, termed as PICS-Family (PICS-F).[1, 2]

PICS is defined as new or worsening impairment in physical (ICU-acquired neuromuscular weakness), cognitive (thinking and judgment), or mental health status arising after critical illness and persisting beyond discharge from the acute care setting.[1, 2]

Methods: We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations.

Conclusion: The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new recommendations in further releases of these guidelines.

ICU teams are multi-disciplinary, made up of highly skilled intensive care nurses, doctors and specialists trained in providing critical care for patients with a variety of medical, surgical and trauma conditions.

This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.

Methods: An international consensus panel was convened including 29 clinician-scientists in intensive care medicine with expertise in acute respiratory failure, neurointensive care, or both, and two non-voting methodologists. The panel was divided into seven subgroups, each addressing a predefined clinical practice domain relevant to patients admitted to the intensive care unit (ICU) with ABI, defined as acute traumatic brain or cerebrovascular injury. The panel conducted systematic searches and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to evaluate evidence and formulate questions. A modified Delphi process was implemented with four rounds of voting in which panellists were asked to respond to questions (rounds 1-3) and then recommendation statements (final round). Strong recommendation, weak recommendation, or no recommendation were defined when > 85%, 75-85%, and

Conclusions: This consensus provides guidance for the care of patients admitted to the ICU with ABI. Evidence was generally insufficient or lacking, and research is needed to demonstrate the feasibility, safety, and efficacy of different management approaches.

The Medical-Surgical Intensive Care Unit (MSICU) provides post-surgical care for children and young adults following general surgery, transplantation, neurosurgery, craniofacial reconstruction, orthopedic surgery, and trauma. Our MISCU has one of the highest volume pediatric intensive care units in the U.S. and is one of the largest extracorporeal membrane oxygenation (ECMO) centers. Learn about the MSICU.

The Cardiac Intensive Care Unit (CICU) cares for some of the most complex heart conditions in the world. We treat children with non-surgical conditions, such as heart failure, single ventricle defects, and hypoplastic left heart syndrome, and children with heart disease undergoing non-cardiac surgery. We also treat older patients and adults who have developed complications or need further procedures as a result of long-standing or previously treated congenital heart disease. We are one of the largest and most sophisticated pediatric cardiac intensive care units in the country. Find out more about the CICU.

The Neonatal Intensive Care Unit (NICU) treats critically ill infants requiring complex medical and surgical care. We work closely with the Maternal Fetal Care Center to coordinate both prenatal consultation and postnatal intensive care for infants with a wide range of prenatally diagnosed conditions. Infants admitted to the NICU are frequently referred from community hospitals because they require advanced medical or surgical therapies not available where they were born. Learn about the NICU. 041b061a72


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