scholarly journals Transition to an In-House Night Float System for Critical Care Fellows: Resident Experience, Morbidity, and Mortality in a Rural Academic Hospital

Cureus ◽  
2021 ◽  
Author(s):  
Kyle D Chapman ◽  
Varun Badami ◽  
Lauren Stawovy ◽  
Sana Ali ◽  
Mohamad Abdelfattah
Keyword(s):  
Critical Care ◽  
Morbidity And Mortality ◽  
Academic Hospital ◽  
Night Float

scholarly journals Separate Consent for Anesthetic Practice: Need of the Moment

2020 ◽  
Vol 42 (3) ◽  
pp. 1-6
Author(s):  
Anil Shrestha ◽  
Gentle S Shrestha ◽  
Saurabh Pradhan ◽  
Pankaj Joshi
Keyword(s):  
Critical Care ◽  
Pain Management ◽  
Older Patients ◽  
Morbidity And Mortality ◽  
Daily Routine ◽  
Anaesthetic Practice ◽  
Patient Morbidity ◽  
Enormous Amount ◽  
Primary Physicians ◽  
The Moment

Decades of refinement and modifications have led the modern anaesthetic practice to be conducted so smoothly and safely, that sometimes we take for granted the enormous amount of risks involved with it. Furthermore, with the evolution of monitoring techniques, and discovery of safer drugs, anesthesia has facilitated the conduction of complex surgeries on sicker patients, and older patients. The expansion to critical care and pain management services has added another dimension to this field, with anesthesiologists not just working as facilitators for another procedure, but acting as primary physicians. Anesthesiologists are among the few clinicians, who are involved in patient morbidity and mortality in their daily routine. With the ever-changing ethical and legal background, the significance of obtaining a separate consent for anesthesia needs to be timely evaluated. In this review, we have discussed the significance of a separate consent for anesthesia and highlight its various aspects.

Morbidity and mortality of acute renal failure in the Critical Care Unit of a regional hospital

2018 ◽  
Vol 65 (6) ◽  
pp. 314-322
Author(s):  
M.E. Esteban Ciriano ◽  
J.M. Peña Porta ◽  
C. Vicente de Vera Floristán ◽  
S. Olagorta García ◽  
R. Álvarez Lipe ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Critical Care ◽  
Critical Care Unit ◽  
Regional Hospital ◽  
Morbidity And Mortality

scholarly journals A History of Cerebrovascular Disease Is Independently Associated with Increased Morbidity and Mortality in Patients with COVID-19: A Cohort Study of 369,563 COVID-19 Cases in the USA

2021 ◽  
pp. 1-9
Author(s):  
Anna M. Nia ◽  
Visish M. Srinivasan ◽  
Miranda K. Hayworth ◽  
Rishi R. Lall ◽  
Peter Kan
Keyword(s):  
Critical Care ◽  
Cerebrovascular Disease ◽  
Morbidity And Mortality ◽  
Prior History ◽  
Care Services ◽  
Relative Risks ◽  
Previous Diagnosis ◽  
Increased Risk ◽  
The Usa ◽  
History Of

<b><i>Objectives:</i></b> We set out to evaluate the risk for severe coronavirus disease 2019 (COVID-19) infection and subsequent cerebrovascular disease (CVD) in the population with a prior diagnosis of CVD within the past 10 years. <b><i>Methods:</i></b> We utilized the TriNetX Analytics Network to query 369,563 CO­VID-19 cases up to December 30, 2020. We created 8 cohorts of patients with COVID-19 diagnosis based on a previous diagnosis of CVD. We measured the odds ratios, relative risks, risk differences for hospitalizations, ICU/critical care services, intubation, mortality, and CVD recurrence within 90 days of COVID-19 diagnosis, compared to a propensity-matched cohort with no prior history of CVD within 90 days of COVID-19 diagnosis. <b><i>Results:</i></b> 369,563 patients had a confirmed diagnosis of COVID-19 with a subset of 22,497 (6.09%) patients with a prior diagnosis of CVD within 10 years. All cohorts with a CVD diagnosis had an increased risk of hospitalization, critical care services, and mortality within 90 days of COVID-19 diagnosis. Additionally, the data demonstrate that any history of CVD is associated with significantly increased odds of subsequent CVD post-COVID-19 compared to a matched control. <b><i>Conclusions:</i></b> CVD, a known complication of CO­VID-19, is more frequent in patients with a prior history of CVD. Patients with any previous diagnosis of CVD are at higher risks of morbidity and mortality from COVID-19 infection. In patients admitted to the ED due to COVID-19 symptoms, these risk factors should be promptly identified as delayed or missed risk stratification and could lead to an ineffective and untimely diagnosis of subsequent CVD, which would lead to protracted hospitalization and poor prognosis.

The Effect of ACGME Duty Hour Restrictions on Operative Continuity of Care

2009 ◽  
Vol 75 (12) ◽  
pp. 1234-1237 ◽  
Author(s):  
Don K. Nakayama ◽  
William M. Thompson ◽  
Julie L. Wynne ◽  
Martin L. Dalton ◽  
Andrew T. Bozeman ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Morbidity And Mortality ◽  
Night Float ◽  
Resident Work ◽  
Operative Complications ◽  
Morbidity And Mortality Conference ◽  
Mortality Conference ◽  
Prior Operation

Resident work restrictions limit participation in operations that address problems created by a prior operation, because complications occur at any time. We compared resident and attending surgeon staffing of operative complications. We reviewed all complications that required a second operation reported at our Morbidity and Mortality Conference over 1 year, noting surgeons present, their postgraduate year level, and call shift. Comparisons were done using χ2. Of 142 cases, 39 involved a second operation. The same attending surgeon was present for both in 79 per cent of cases, whereas the same resident was present in only 44 per cent ( P = 0.002). Postgraduate year 4 to 5 were less likely to be present for second operations than attendings (48% vs 87%, P = 0.011). Resident shift (day, night float, and weekend) was known in 32 cases. When the first operation occurred during day hours, attendings and residents were equally likely to be present at the second (55% and 45%, P = 0.16). When original operations took place during night float or weekend shifts, residents were less likely to be present (33%) than attendings (83%) at second operations ( P = 0.036). Duty hour restrictions interfere with operative continuity of care. Reoperations should be exempted from duty hour restrictions.

389: IMPROVING CRITICAL CARE MORBIDITY AND MORTALITY CONFERENCE: THE OTTAWA MODEL

2018 ◽  
Vol 46 (1) ◽  
pp. 177-177
Author(s):  
Zachary Grossbaum ◽  
Akiva Dym ◽  
Nima Hani ◽  
Adam Keene ◽  
Lewis Eisen
Keyword(s):  
Critical Care ◽  
Morbidity And Mortality ◽  
Morbidity And Mortality Conference ◽  
Mortality Conference

Providing Palliative Care in the Medical ICU: A Qualitative Study of MICU Physicians' Beliefs and Practices

2018 ◽  
Vol 35 (10) ◽  
pp. 1309-1313 ◽  
Author(s):  
Brittany Gatta ◽  
Jessica Turnbull
Keyword(s):  
Palliative Care ◽  
Critical Care ◽  
Qualitative Study ◽  
Interrater Reliability ◽  
Integrative Model ◽  
Personal Satisfaction ◽  
Academic Hospital ◽  
Beliefs And Practices ◽  
Semistructured Interviews ◽  
Enhance Patient Care

Context: With the current and projected shortage of palliative care (PC) specialists, an integrative model of PC will be needed to meet the needs of patients in intensive care units (ICUs). Prior studies of PC interventions suggest that success depends upon meeting the needs of individual institutions or ICUs. Objective: The objective of this study was to qualitatively explore the beliefs and practices of one institution’s medical ICU (MICU) physicians in regard to providing an integrative model of PC. Methods: This qualitative study used semistructured interviews of 17 physicians within a Department of Allergy, Pulmonary, and Critical Care Medicine at one large academic hospital. Interviews were conducted, transcribed, and coded according to qualitative research methods. Selected interviews were tested for interrater reliability and negotiated agreeability. Results: All critical care physicians interviewed affirmed that providing PC was part of their job, and the majority expressed that providing PC gave them professional or personal satisfaction. Physicians also identified many ways that PC consultants enhance patient care in the MICU. They discussed several motivations for obtaining a PC consult, with the most frequently acknowledged motivation being lack of time. Conclusion: Developing an integrative model of PC in the ICU ought to take into account both studied interventions shown likely to be effective in the ICU setting and the specific needs and barriers to PC in that unit. This study demonstrates one way that needs and barriers can be identified and provides important findings that might be applicable to other institutions.

Intracerebral and Intraventricular Hemorrhage

2019 ◽  
pp. 570-576
Author(s):  
Oana Dumitrascu ◽  
Maria I. Aguilar
Keyword(s):  
Critical Care ◽  
Cerebral Hemorrhage ◽  
Intraventricular Hemorrhage ◽  
Care Management ◽  
Multidisciplinary Approach ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
Critical Care Management ◽  
Individualized Management

Intraparenchymal cerebral hemorrhage and intraventricular hemorrhage are common cerebrovascular emergencies with various causes and prognoses. Rapid triage and individualized management are required because appropriate critical care management improves morbidity and mortality. A multidisciplinary approach for diagnosis and treatment is recommended.

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