Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

7 results

  • Chapter 4 - Transfer of the critically ill

  • from Section I: - Specific features of critical care medicine
  • Edited by Fang Gao Smith, University of Warwick
  • Edited in association with Joyce Yeung
  • Book:
    Core Topics in Critical Care Medicine
    Published online:
    06 July 2010
    Print publication:
    22 April 2010, pp 21-26

  • Summary

    It is estimated that in excess of 10,000 critically ill or injured patients are transferred between hospitals each year in the UK. The optimal mode of transport selected for a patient transfer depends upon a number of factors. These include: the indication for, and urgency of, transfer; time to organize/mobilize transport; weather and traffic conditions; space; and cost. Current guidelines recommend that a minimum of two people accompany the transfer of a critically ill patient in addition to the staff required to operate the transport vehicle. The decision to transfer a critically ill patient is usually shared between the critical care consultants at the referring and receiving hospitals in collaboration with their consultant colleagues in the relevant specialities. Continuous monitoring of the ECG, SpO2 blood pressure and ETCO2 should be maintained throughout the transfer and recorded on the patient transfer sheet.

  • Chapter 22 - Post-resuscitation care

  • from Section II: - Systemic disorders and management
  • Edited by Fang Gao Smith, University of Warwick
  • Edited in association with Joyce Yeung
  • Book:
    Core Topics in Critical Care Medicine
    Published online:
    06 July 2010
    Print publication:
    22 April 2010, pp 170-176

  • Summary

    Ordinarily, when discussing treatment options with a patient, doctors manage to fulfill an ethical obligation by ensuring that the patient's treatment choices are accommodated as far as possible. The four key ethical principles are: beneficence, non-maleficence, respect for autonomy, and justice. One of the cornerstones of good medical practice is that before providing treatment or involving a patient in teaching, or research, doctors must be satisfied that they have a valid authority. Usually this requires the patient to consent to the proposed treatment. In critical care the hardest decisions are those concerning when to withhold or withdraw treatment. Despite this the majority of patients who die in critical care departments do so after a decision to withhold or withdraw life-prolonging care. When considering end-of-life issues, good communication with patients and their relatives is essential for establishing priorities and ensuring that the wishes of the patient are paramount.

  • 20 - Pharmacology of cardiac arrest and reperfusion

  • from Part III - The pathophysiology of global ischemia and reperfusion
    • By Tommaso Pellis, The University Laboratory of Physiology, Oxford, UK, Clinical and Medical Affairs, Biosite Incorporated, San Diego, CA, USA, Jasmeet Soar, The University Laboratory of Physiology, Oxford, UK, Clinical and Medical Affairs, Biosite Incorporated, San Diego, CA, USA, Gavin Perkins, The University Laboratory of Physiology, Oxford, UK, Clinical and Medical Affairs, Biosite Incorporated, San Diego, CA, USA, Raúl J. Gazmuri, The University Laboratory of Physiology, Oxford, UK, Clinical and Medical Affairs, Biosite Incorporated, San Diego, CA, USA
  • Edited by Norman A. Paradis, University of Colorado, Denver, Henry R. Halperin, The Johns Hopkins University School of Medicine, Karl B. Kern, University of Arizona, Volker Wenzel, Douglas A. Chamberlain, Cardiff University
  • Book:
    Cardiac Arrest
    Published online:
    06 January 2010
    Print publication:
    18 October 2007, pp 395-416

  • Summary

    Introduction

    The pharmacology of resuscitation is largely based on anecdotal evidence and descriptive research rather than on objective scientific experimentation. Our understanding of the pharmacokinetics (PK) and pharmacodynamics (PD) of drugs used to resuscitate victims of cardiac arrest is also limited by ethical and experimental constraints.

    Animal models of cardiac arrest and cardiopulmonary resuscitation (CPR), jointly with clinical studies, have considerably increased our understanding of the pathophysiology of cardiac arrest and significantly improved our ability to resuscitate victims of cardiac arrest. The great majority of such studies, however, were designed to address interventions to improve resuscitation rather than to investigate the pharmacological profile of drugs used in settings of cardiac arrest and reperfusion. Even less evidence is available on the PK of administration of multiple drugs, a more complex but realistic scenario. During resuscitative efforts, i.e., low flow reperfusion, significant shunting of blood to vital organs occurs. The use of vasopressors in this setting further modifies the patterns of blood flow distribution, in all likelihood affecting the PK of concomitantly administered drugs.

    The time from onset of cardiopulmonary arrest until restoration of an effective spontaneous circulation is the single most important determinant of long-term survival and neurological outcome. Prompt initiation of CPR and defibrillation of ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) are more likely to alter patient outcome than is pharmacologic management. Nevertheless, treatment with pharmacologic agents is frequently required in patients with VF or VT that is refractory to electrical shocks and in patients with asystole or pulseless electrical activity (PEA).