Critical Care Alert 2002-12-01

Are Thrombolytics Needed in Submassive Pulmonary Embolism?

In this randomized, double-blind study, 256 patients with submassive pulmonary embolism (PE) were treated with either heparin or heparin plus alteplase, a thrombolytic agent.

Discharge Time, Discharge TISS Scores, and Discharge Facility and Post-ICU Discharge Hospital Mortality

Intensive care is part of a continuum of progressive patient care, and a significant number of research groups are now focusing their attention on ways to improve the organization of the ICU and its place in the continuum of care. An important aspect of this process is the evaluation of ICU discharge policies and their consequences.

Special Feature: Reducing Central Venous Catheter-Related Bloodstream Infections

Intravascular catheters are an essential component of the practice of critical care medicine. These devices are used to deliver life-sustaining intravenous fluids, antibiotics, parenteral nutrition, blood, and blood products, and to monitor the hemodynamic status of critically ill patients.

Critical Care Plus: Intra-Hospital Patient Transport Fraught With Difficulties

Whats the single most important thing intensive care units can do to avoid the disasters that can happen when patients are transported to and from hospital departments? The most important factor is having a critical care doctor or head ICU nurse present to quarterback the move, says pediatrician Robert F. Patterson, MD, FAAP, critical care intensivist at Nemours Childrens Clinic in Pensacola, Fla.

Critical Care Plus: Magnet Hospitals Increase Quality of Nursing Care

With the health care penny being squeezed dry its not unexpected that nurses report they are unable to provide quality of care consistent with professional standards in todays hospitals, says Julie Sochalski, RN, PhD, professor of nursing at the University of Pennsylvania School of Nursing.

Critical Care Plus: ICU Lawsuits Over Withholding Support Are Urban Myth, Expert Says

Health care providers are understandably concerned about the legal climate in which they live, observes Marshall B. Kapp, JD, MPH, professor in the department of community health at Wright State University School of Medicine in Dayton, Ohio. But ICU physicians can rest easier than many. Even though malpractice cases abound, the reality is that very few medical malpractice claims or other adverse legal actions happen due to thoughtful decisions to withhold or withdraw treatment for dying patients in the ICU.

Critical Care Plus: Group Closing GAP in Heart Attack Care

A team of 10 detroit-area hospitals, led by physicians from the University of Michigan Health System in Ann Arbor, has reported significant success in improving the odds that heart attack patients will get the medicines, tests, procedures, counseling, and follow-ups that have been shown to improve the chances of surviving and returning to a full life.

Clinical Briefs in Primary Care Supplement

Critical Care Alert – December 1, 2002

December 1, 2002