Critical Illness Outside the ICU, An Issue of Critical Care Clinics

1st Edition, Volume 40-3 - May 29, 2024
Editors: David N. Hager, Kyle Gunnerson, Stephen Macdonald
Language: English
Hardback ISBN:
9 7 8 - 0 - 4 4 3 - 2 9 4 9 0 - 7
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 2 9 4 9 1 - 4

In this issue of Critical Care Clinics, guest editors Drs. David N. Hager, Kyle Gunnerson, and Stephen Macdonald bring their considerable expertise to the topic of Critic… Read more

Critical Illness Outside the ICU, An Issue of Critical Care Clinics

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In this issue of Critical Care Clinics, guest editors Drs. David N. Hager, Kyle Gunnerson, and Stephen Macdonald bring their considerable expertise to the topic of Critical Illness Outside the ICU. Top experts cover key topics such as flight transport of the critically ill; models of critical care in the emergency department; in-hospital triage; rapid response teams; early warning systems; ICU without walls; and more.

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Preface
Critical Care in the Austere Environment
Key points
Introduction
Definition of austere critical care
Response to a disaster in resource-rich areas
Response to disasters in resource-poor areas
Air transport
Triage
Systems based support
Summary
Clinics care points
Advanced Critical Care Techniques in the Field
Key points
Introduction
Resuscitative endovascular balloon occlusion of the aorta
Thrombolytic administration for acute stroke
Prehospital low-titer group O whole blood transfusion
Prehospital applications of critical care monitoring: capnography and ultrasound
Summary
Clinics care points
Aeromedical Transport for Critically Ill Patients
Key points
Introduction
Personnel and equipment
Evidence of benefit
Safety concerns
Evidence-based indications
Physiologic considerations for aeromedical transport
Summary
Clinics care points
Critical Care Delivery in the Emergency Department: Bringing the Intensive Care Unit to the Patient
Key points
Introduction
Emergency Department-critical care delivery models
Summary
Clinics care points
The Role of Intermediate Care in Supporting Critically Ill Patients and Critical Care Infrastructure
Key points
Introduction
Origins and rationale for intermediate care
Early experience with intermediate care
Multicenter studies examining the effect of intermediate care on intensive care unit outcomes
Multicenter studies characterizing outcomes of patients admitted to intermediate care
Intermediate care and specific populations
Organization of intermediate care
Economics of intermediate care
Intermediate care guidelines
Future study of intermediate care
Summary
Clinics care points
Where the Postanesthesia Care Unit and Intensive Care Unit Meet
Key points
Introduction
Critical illness in the postanesthesia care unit and phases of recovery
Critical care staffing in the postanesthesia care unit
Overlapping postanesthesia care unit and intensive care unit management strategies
Transitions in care between the postanesthesia care unit and intensive care unit
Point of care ultrasound in the postanesthesia care unit
Challenges
Lessons from the COVID-19 pandemic
Summary
Clinics care points
In-Hospital Triage
Key points
Introduction
Background
Discussion
Summary
Clinics care points
Intensive Care Unit Without Walls
Key points
Background
Rapid response systems
Afferent alerting systems
Patient- and relative-initiated escalation
Early management of critical illness and provision of organ support outside the Intensive Care Unit
Supporting staff following intensive care unit discharge
Family visiting hours
Intensive care unit follow-up services
Technological support
Audit and quality improvement
Outcomes
Treatment escalation planning
Opportunities for cross-border collaboration
Summary
Clinics care points
Early Warning Systems for Critical Illness Outside the Intensive Care Unit
Key points
Introduction
The evolution of early warning systems
Building an early warning system
Early warning systems in clinical practice
Clinics care points
Rapid Response Systems
Key points
Introduction
The rationale for a rapid response system
Rapid response system structure
Rapid response system effectiveness
Mortality
Incidence of cardiopulmonary arrest
Rapid response system failure
Afferent limb modification
Efferent limb modification
Unintended consequences of rapid response systems
Economics
End-of-life care
Summary
Clinics care points
Tele-Critical Care Support Outside the Intensive Care Unit
Key points
Introduction
Summary
Clinics care points
Critical Illness Outside the Intensive Care Unit: Research Challenges in Emergency and Prehospital Settings
Key points
Introduction
World Medical Association Declaration of Helsinki
Case study
A requirement to obtain prior consent for time critical research does not protect patients and may cause harm
Consent waivers or exception from informed consent
Community consultation and acceptance of research without consent in time critical emergencies
Consent processes should be proportionate to the incremental risk of research participation
Case study: PARAMEDIC 2 trial
Aspects of study design
Lessons from the coronavirus disease 2019 pandemic
Summary
Clinics care points

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Critical Illness Outside the ICU, An Issue of Critical Care Clinics

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David N. Hager

Kyle Gunnerson

Stephen Macdonald