Oxford Desk Reference: Critical Care最新文献

{"title":"Looking after critically ill children","authors":"C. Waldmann, A. Rhodes, N. Soni, J. Handy","doi":"10.1093/MED/9780198723561.003.0035","DOIUrl":"https://doi.org/10.1093/MED/9780198723561.003.0035","url":null,"abstract":"This chapter discusses paediatrics in critical care and includes discussion on both paediatric transfers for the adult intensivist and looking after a vulnerable child (safeguarding children for the adult practitioner). With the centralization of specialist services into a limited number of hospitals across the UK, an increasing number of children require an interhospital transfer. These include but are not limited to the transfer of the critically ill child. Between 2012 and 2014, 18 500 transfers of critically ill or injured children were undertaken across the UK, of which 2400 were undertaken by non-specialist teams. These patients are some of the sickest children. It is while in transit that these patients are most at risk and the transferring team is most exposed. To minimize risks it is important that the team holds the relevant skills to stabilize and transfer children. A systematic approach is vital. The patient’s condition should be optimized before transfer and any likely difficulties anticipated and a plan to tackle any complications swiftly and effectively is agreed prior to the transfer. In this chapter we offer our approach to the safe transfer of the critically ill child. The second part of this chapter offers an introduction into the safeguarding of vulnerable children. A 2009 survey conducted by the National Society for the Prevention of Cruelty to Children asking children to self-report abuse and neglect found that 18.6% of 11–17-year-olds said they had experienced some type of severe maltreatment. The high prevalence of child abuse makes it likely for the medical practitioner who is mostly caring for adult patients to encounter vulnerable children in clinical practice. This will often happen when participating in the resuscitation of a critically ill or injured child, when anaesthetizing a child, or when looking after a caregiver of such a child. The aim of this chapter is to provide these practitioners with the information that will help them to identify possible child abuse and make them aware of their responsibilities towards these children and their options for action.","PeriodicalId":406870,"journal":{"name":"Oxford Desk Reference: Critical Care","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129416653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shock","authors":"C. Waldmann, A. Rhodes, N. Soni, J. Handy","doi":"10.1093/med/9780198723561.003.0027","DOIUrl":"https://doi.org/10.1093/med/9780198723561.003.0027","url":null,"abstract":"This chapter discusses shock and includes a definition and diagnosis, discussion on hypovolaemic shock (including causes of hypovolaemic shock, therapy, and the reperfusion phase), cardiogenic shock, anaphylactic shock (including pathophysiology), and pathophysiology of sepsis and multiorgan failure.","PeriodicalId":406870,"journal":{"name":"Oxford Desk Reference: Critical Care","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134049193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological monitoring","authors":"C. Waldmann, A. Rhodes, N. Soni, J. Handy","doi":"10.1093/med/9780199229581.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780199229581.003.0008","url":null,"abstract":"Dealing with neurological critically ill patients is one of the most challenging situations in intensive care. The range of conditions can go from carbon dioxide narcosis to status epilepticus or hypoxic or traumatic brain injuries. The key difficulty is the neurological assessment of these patients while they require general anaesthesia. This chapter discusses neurological monitoring and includes discussion on intracranial pressure (ICP) monitoring (including indications for ICP monitoring, methods of measuring ICP, complications of ICP monitoring, and ICP in normal and pathological conditions), intracranial perfusion (regulation of cerebral perfusion and measurement of cerebral blood flow), electroencephalogram (EEG) and cerebral function analysing monitoring (CFAM) (EEG, cerebral function monitors (CFM)/CFAM, EEG terminology, and clinical use in the intensive care unit), and other forms of neurological monitoring (tissue metabolism, cerebral blood flow and metabolism, and peripheral nerve and muscle electrophysiology).","PeriodicalId":406870,"journal":{"name":"Oxford Desk Reference: Critical Care","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115467706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological disorders","authors":"C. Waldmann, A. Rhodes, N. Soni, J. Handy","doi":"10.1093/med/9780198723561.003.0023","DOIUrl":"https://doi.org/10.1093/med/9780198723561.003.0023","url":null,"abstract":"This chapter discusses neurological disorders and includes discussion on delirium, status epilepticus, meningitis and encephalitis, intracerebral haemorrhage, subarachnoid haemorrhage, ischaemic stroke, Guillain–Barré syndrome, myasthenia gravis, intensive care unit-acquired weakness, tetanus, botulism, rehabilitation and critical illness, and hyperthermias. The aim is to provide a summary of the extensive complex neuological pathologies that can present to an intensive care clinician. Where appropriate, descriptions are provided on clinical presentation, epidemiology, diagnosis (including investigations), and management. Of note, some of the conditions covered can arise on the ward or prehospital environments with subsequent requirement for intensive care, but they can also arise de novo on the intensive care unit itself, highlighting the need for intensive care clinicians to maintain a broad knowledge and understanding of their presentation and management.","PeriodicalId":406870,"journal":{"name":"Oxford Desk Reference: Critical Care","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124558248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluids","authors":"C. Waldmann, A. Rhodes, N. Soni, J. Handy","doi":"10.1093/med/9780198723561.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780198723561.003.0010","url":null,"abstract":"Fluid therapy is probably one of the most common interventions in intensive care medicine, after administration of oxygen. Fluids are drugs. The choice of the type of fluid, the dose, indications, and side-effects are crucially important. This chapter discusses fluids and includes discussion on crystalloids, colloids, sodium bicarbonate (including discussion on common indications for sodium bicarbonate administration, potential and theoretical dangers of sodium bicarbonate administration, sodium bicarbonate preparations, and sodium bicarbonate in dialysate fluids), and blood (describing laboratory testing for coagulopathy and blood components commonly available in the UK).","PeriodicalId":406870,"journal":{"name":"Oxford Desk Reference: Critical Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131157791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Death and dying","authors":"R. Rhodes","doi":"10.1038/NPG.ELS.0003484","DOIUrl":"https://doi.org/10.1038/NPG.ELS.0003484","url":null,"abstract":"","PeriodicalId":406870,"journal":{"name":"Oxford Desk Reference: Critical Care","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2003-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132847810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}