Critical Care Pharmacy Services in United States Hospitals

2006 ◽  
Vol 40 (4) ◽  
pp. 612-618 ◽  
Author(s):  
Robert MacLaren ◽  
John W Devlin ◽  
Steven J Martin ◽  
Joseph F Dasta ◽  
Maria I Rudis ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
Pharmacy Services

scholarly journals Characterizing Critical Care Pharmacy Services Across the United States

2021 ◽  
Vol 3 (1) ◽  
pp. e0323
Author(s):  
Robert MacLaren ◽  
Russel J. Roberts ◽  
Amy L. Dzierba ◽  
Mitchell Buckley ◽  
Ishaq Lat ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
The United States ◽  
Pharmacy Services

Regionalization of Critical Care in the United States

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sharon Leung ◽  
Stephen M. Pastores ◽  
John M. Oropello ◽  
Craig M. Lilly ◽  
Samuel M. Galvagno ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
The United States

scholarly journals Advances in the Management of Sepsis and the Understanding of Key Immunologic Defects

2011 ◽  
Vol 115 (6) ◽  
pp. 1349-1362 ◽  
Author(s):  
Lee P. Skrupky ◽  
Paul W. Kerby ◽  
Richard S. Hotchkiss
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Operating Room ◽  
The United States ◽  
Difficult Problem ◽  
Treatment Algorithms ◽  
New Treatment ◽  
Overall Mortality

Anesthesiologists are increasingly confronting the difficult problem of caring for patients with sepsis in the operating room and in the intensive care unit. Sepsis occurs in more than 750,000 patients in the United States annually and is responsible for more than 210,000 deaths. Approximately 40% of all intensive care unit patients have sepsis on admission to the intensive care unit or experience sepsis during their stay in the intensive care unit. There have been significant advances in the understanding of the pathophysiology of the disorder and its treatment. Although deaths attributable to sepsis remain stubbornly high, new treatment algorithms have led to a reduction in overall mortality. Thus, it is important for anesthesiologists and critical care practitioners to be aware of these new therapeutic regimens. The goal of this review is to include practical points on important advances in the treatment of sepsis and provide a vision of future immunotherapeutic approaches.

Neonatal Personpower

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 836-837
Author(s):  
GERALD KATZMAN
Keyword(s):  
United States ◽  
Critical Care ◽  
The United States ◽  
Care Needs ◽  
Live Births ◽  
Adequate Number ◽  
Lengths Of Stay ◽  
The Difference ◽  
Power Needs

To the Editor.— There have been several attempts to define the person-power needs for neonatologists in the United States.1-3 The reports by Merenstein et al2 and the AAP Committee on Fetus and Newborn1 maintain that there is presently an adequate number of neonatologists, whereas in a 1981 editorial, Robertson3 predicted increasing shortages of neonatologists. Why the difference between the conclusions? My answer to this question is that the reports by Merenstein et al and the AAP used calculated ratios of neonatologists to live births or lengths of stay, whereas the Robertson editorial expressed concern about the critical care needs of the physiologically unstable neonate.

Workforce demographics and unit structure in paediatric cardiac critical care in the United States

2021 ◽  
pp. 1-5
Author(s):  
Robin V. Horak ◽  
Shasha Bai ◽  
Bradley S. Marino ◽  
David K. Werho ◽  
Leslie A. Rhodes ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
Heart Surgery ◽  
Age Groups ◽  
The United States ◽  
Work Hours ◽  
Full Time ◽  
Full Time Equivalent ◽  
Unit Structure ◽  
Cardiac Critical Care

Abstract Objective: To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States. Design: REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure. Measurements and main results: Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%). Conclusions: Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.

Severity of Illness Scoring Systems in Critical Care

2015 ◽  
Author(s):  
Mark T. Keegan
Keyword(s):  
United States ◽  
Critical Care ◽  
Organ Failure ◽  
Severity Of Illness ◽  
Scoring Systems ◽  
The United States ◽  
Prognostic Models ◽  
Fourth Generation ◽  
Risk Of Death ◽  
Predicted Risk

Critical care consumes about 4% of national health expenditure and 0.65% of United States gross domestic product. There are approximately 94,000 critical care beds in the United States, and provision of critical care services costs approximately $80 billion per year. The enormous costs and the heterogeneity of critical care have led to scrutiny of patient outcomes and cost-effectiveness by a variety of governmental and nongovernmental organizations; furthermore, individual critical care practitioners and their hospitals should evaluate the care delivered. This review discusses scoring systems in medicine, critical care systems, development, validation, performance, and customization of the models, adult intensive care unit (ICU) prognostic models, model use, limitations, prognostic models in trauma care, perioperative scoring systems, assessment of organ failure, severity of illness and organ dysfunction scoring in children, and future directions. Figures show the distribution of predicted risk of death using two different prediction models among a population of patients who ultimately are observed to either live or die, a comparison of  “expected” deaths (based on the expectation that the predicted probability from the model is correct) to observed deaths within each of the 10 deciles of predicted risk, the importance of disease in the risk of death equation,  and the revised Rapaport-Teres graph for ICUs in the Project IMPACT validation set. Tables list three main ICU prognostic models, study characteristics and performance of the fourth-generation prognostic models, variables included in the fourth-generation prognostic models, potential uses of adult ICU prognostic models, variables included in the calculation of the organ failure scores, and sequential organ failure assessment. This review contains 4 highly rendered figures, 6 tables, and 293 references

Tracheostomy

2019 ◽  
pp. 850-854
Author(s):  
Saba Ghorab ◽  
David G. Lott
Keyword(s):  
United States ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prolonged Mechanical Ventilation ◽  
The United States ◽  
Critical Care Patients

Tracheostomy is a procedure where a conduit is created between the skin and the trachea. Tracheostomy is one of the most frequent procedures undertaken in critically ill patients. Each year, approximately 10% of critical care patients in the United States require a tracheostomy, most often for prolonged mechanical ventilation.

scholarly journals 53. A Descriptive Analysis of Air Medical Directors in the United States

1996 ◽  
Vol 11 (S2) ◽  
pp. S44-S44
Author(s):  
Kathy J. Rinnert ◽  
Ira J. Blumen ◽  
Michael Zanker ◽  
Sheryl G. A. Gabram
Keyword(s):  
Internal Medicine ◽  
United States ◽  
Emergency Medicine ◽  
Critical Care ◽  
Descriptive Analysis ◽  
The United States ◽  
Air Transport ◽  
Medical Services ◽  
Medical Directors ◽  
Mission Profile

Purpose: The practice of helicopter emergency medical services is variable in its mission profile, crew configuration, and transport capabilities. We sought to describe the characteristics of physician air medical directors in the United States.Methods: We surveyed medical directors concerning their education, training, transport experience, and roles/responsibilities in critical care air transport programs.Results: Two page surveys were mailed to 281 air medical services. Three programs merged or were dissolved. Data from 122/278 (43.9%) air medical directors were analyzed. One-hundred eleven respondents reported residency training in: Emergency Medicine (EM) 44 (39.6%), Internal Medicine (IM) 18 (16.2%), General Surgery (GS) 18 (16.2%), Family Practice (FP) 12 (10.8%), dual-trained (EM/IM, EM/FP, IM/FP) 11 (9.9%) and others 8 (7.2%). Medical directors’ roles/responsibilities consist, most frequently of: drafting protocols 108 (88.5%), QA/CQI activities 104 (85.3%), crew training 98 (80.3%), and administrative negotiations 95 (77.7%).

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