Tele-Critical Care Support Outside the Intensive Care Unit
Tele-intensive care unit (ICU), or Tele Critical Care (TCC), has been in active use for 25 years and has expanded beyond the original model to support critically ill patients beyond the confines of the ICU. Here, the author reviews the role of TCC in supporting rapid response events, critical care in emergency departments, and disaster and pandemic responses. The ability to rapidly expand critical care services has important capacity and care quality implications. Moreover, as TCC infrastructure becomes less expensive, the opportunities to leverage this care modality also have potentially important financial benefits. (Sou...
Source: Critical Care Clinics - April 25, 2024 Category: Intensive Care Authors: Jonathan M. Siner Source Type: research
Aeromedical Transport for Critically Ill Patients
Aeromedical transport (AMT) is an integral part of healthcare systems worldwide. In this article, the personnel and equipment required, associated safety considerations, and evidence supporting the use of AMT is reviewed, with an emphasis on helicopter emergency medical services (HEMS). Indications for HEMS as guideded by the Air Medical Prehospital Triage Score are presented. Lastly, physiologic considerations, which are important to both AMT crews and receiving clinicians, are reviewed. (Source: Critical Care Clinics)
Source: Critical Care Clinics - April 23, 2024 Category: Intensive Care Authors: Christopher Parrino, Samuel M. Galvagno Source Type: research
Rapid Response Systems
The hospital rapid response system (RRS) is a patient safety and quality intervention that responds quickly to clinical deteriorations on general wards with the goal of preventing cardiopulmonary arrests, reducing hospital mortality, and facilitating triage and level of care escalations. The RRS is one of the first organized, and systematic, elements of the “ICU without walls” model. RRSs have been shown to be effective in preventing deterioration to cardiopulmonary arrest on general hospital wards and reducing total and unexpected hospital mortality. Recent studies have demonstrated that this benefit can be enhanced t...
Source: Critical Care Clinics - April 23, 2024 Category: Intensive Care Authors: Bradford D. Winters Source Type: research
Early Warning Systems for Critical Illness Outside the Intensive Care Unit
Early warning systems (EWSs) are designed and deployed to create a rapid assessment and response for patients with clinical deterioration outside the intensive care unit (ICU). These models incorporate patient-level data such as vital signs and laboratory values to detect or prevent adverse clinical events, such as vital signs and laboratories to allow detection and prevention of adverse clinical events such as cardiac arrest, intensive care transfer, or sepsis. The applicability, development, clinical utility, and general perception of EWS in clinical practice vary widely. Here, we review the field as it has grown from ea...
Source: Critical Care Clinics - April 21, 2024 Category: Intensive Care Authors: Katharine E. Henry, Heather M. Giannini Source Type: research
Critical Illness Outside the Intensive Care Unit: Research Challenges in Emergency and Prehospital Settings
Patients with acute critical illness require prompt interventions, yet high-quality evidence supporting many investigations and treatments is lacking. Clinical research in this setting is challenging due to the need for immediate treatment and the inability of patients to provide informed consent. Attempts to obtain consent from surrogate decision-makers can be intrusive and lead to unacceptable delays to treatment. These problems may be overcome by pragmatic approaches to study design and the use of supervised waivers of consent, which is ethical and appropriate in situations where there is high risk of poor outcome and...
Source: Critical Care Clinics - April 21, 2024 Category: Intensive Care Authors: Stephen Macdonald, Daniel Fatovich, Judith Finn, Edward Litton Source Type: research
Advanced Critical Care Techniques in the Field
Critical care principles and techniques continue to hold promise for improving patient outcomes in time-dependent diseases encountered by emergency medical services such as cardiac arrest, acute ischemic stroke, and hemorrhagic shock. In this review, the authors discuss several current and evolving advanced critical care modalities, including extracorporeal cardiopulmonary resuscitation, resuscitative endovascular occlusion of the aorta, prehospital thrombolytics for acute ischemic stroke, and low-titer group O whole blood for trauma patients. Two important critical care monitoring technologies —capnography and ultrasoun...
Source: Critical Care Clinics - April 17, 2024 Category: Intensive Care Authors: Elizabeth Powell, Alex P. Keller, Samuel M. Galvagno Source Type: research
In-Hospital Triage
This article reviews these concepts and methods of in-hospital triage. (Source: Critical Care Clinics)
Source: Critical Care Clinics - April 16, 2024 Category: Intensive Care Authors: Manoj L. Karwa, Ali Abbas Naqvi, Melanie Betchen, Ajay Kumar Puri Source Type: research
Intensive Care Unit Without Walls
Critical illness is a continuum with different phases and trajectories. The “Intensive Care Unit (ICU) without walls” concept refers to a model whereby care is adjusted in response to the patient’s needs, priorities, and preferences at each stage from detection, escalation, early decision making, treatment and organ support, followed by recovery and rehabilitation, wi thin which all healthcare staff, and the patient are equal partners. The rapid response system incorporates monitoring and alerting tools, a multidisciplinary critical care outreach team and care bundles, supported with education and training, analytica...
Source: Critical Care Clinics - April 16, 2024 Category: Intensive Care Authors: Guy Glover, Victoria Metaxa, Marlies Ostermann Source Type: research
The Role of Intermediate Care in Supporting Critically Ill Patients and Critical Care Infrastructure
Intermediate care (IC) is used for patients who do not require the human and technological support of the intensive care unit (ICU) yet require more care and monitoring than can be provided on general wards. Though prevalent in many countries, there is marked variability in models of organization and staffing, as well as monitoring and interventions provided. In this article, the authors will discuss the historical background of IC, review the impact of IC on ICU and IC patient outcomes, and highlight where future studies can shed light on how to optimize IC organization and outcomes. (Source: Critical Care Clinics)
Source: Critical Care Clinics - April 16, 2024 Category: Intensive Care Authors: Aaron S. Case, Chad H. Hochberg, David N. Hager Source Type: research
Critical Care in the Austere Environment
This article describes the current practice of critical care medicine in the austere environment, using recent natural disasters, pandemics, and conflicts as case studies. (Source: Critical Care Clinics)
Source: Critical Care Clinics - April 12, 2024 Category: Intensive Care Authors: Spencer Lord, Jarone Lee Source Type: research
Diagnosis and Management of Acute Respiratory Failure
CRITICAL CARE CLINICS (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 2, 2024 Category: Intensive Care Authors: Philip Yang, Annette M. Esper Source Type: research
Copyright
ELSEVIER (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 2, 2024 Category: Intensive Care Source Type: research
Contributors
GREGORY S. MARTIN, MD, Msc (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 2, 2024 Category: Intensive Care Source Type: research
Contents
Philip Yang and Annette M. Esper (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 2, 2024 Category: Intensive Care Source Type: research
Forthcoming Issues
Critical Illness Outside the ICU (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 2, 2024 Category: Intensive Care Source Type: research
