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Rapid Response Systems/Fluid Resuscitation, An Issue of Critical Care Clinics, E-Book

Rapid Response Systems/Fluid Resuscitation, An Issue of Critical Care Clinics, E-Book

Michael DeVita | Andrew Shaw

(2018)

Additional Information

Book Details

Abstract

This issue of Critical Care Clinics focuses on Rapid Response Systems and Fluid Resuscitation, with topics including: RRS Now; Triggering Criteria: Big Data; Triggering Criteria: Continuous Monitoring; Measuring instability; Surgery/Trauma RRT; Obstetric RRT; Difficult airway rapid response teams; and Sepsis rapid response teams.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Rapid Response Systems& Fluid Resuscitation i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITORS iii
AUTHORS iii
Contents vii
I: Rapid Response Systems vii
Preface: Why RRS? Where RRS? vii
The Afferent Limb of Rapid Response Systems: Continuous Monitoring on General Care Units vii
Trigger Criteria: Big Data vii
Surgical Rescue in Medical Patients: The Role of Acute Care Surgeons as the Surgical Rapid Response Team vii
Crisis Teams for Obstetric Patients viii
A Decade of Difficult Airway Response Team: Lessons Learned from a Hospital-Wide Difficult Airway Response Team Program viii
Sepsis Rapid Response Teams viii
Intensivist Presence at Code Events Is Associated with High Survival and Increased Documentation Rates viii
II: Fluid Resuscitation ix
Preface: Fluid Therapy in the Critically Ill ix
Applied Physiology of Fluid Resuscitation in Critical Illness ix
Does Fluid Type and Amount Affect Kidney Function in Critical Illness? ix
Blood Product Administration in the Critical Care and Perioperative Settings ix
CRITICAL CARE CLINICS\r x
FORTHCOMING ISSUES x
July 2018 x
October 2018 x
January 2019 x
RECENT ISSUES x
January 2018 x
October 2017 x
July 2017 x
Preface:\rWhy RRS? Where RRS? xi
The Afferent Limb of Rapid Response Systems 189
Key points 189
INTRODUCTION 189
CONTINUOUS MONITORING 190
Desirable Properties of Sensors and the Continuous Monitoring System 192
Physiologic Variables in Continuous Monitoring 192
Sensors Used in Continuous Monitoring 193
Single-sensor monitoring 193
Telemetry and electrocardiogram monitoring 193
Pulse oximetry 193
Piezoelectric sensor 194
Sound-based respiratory rate monitoring 194
Multisensor monitoring 194
ALARM MANAGEMENT 195
DISCUSSION 195
REFERENCES 196
Trigger Criteria 199
Key points 199
INTRODUCTION 199
BIG DATA IN THE HOSPITAL WARDS 200
BIG DATA, EVENT PREDICTION, AND EVENT DETECTION 202
MEDICAL EMERGENCY TEAMS AND RISK STRATIFICATION OF HOSPITALIZED PATIENTS 203
SUMMARY 206
REFERENCES 206
Surgical Rescue in Medical Patients 209
Key points 209
INTRODUCTION 209
FAILURE TO RESCUE: PRINCIPLES AND APPLICATIONS TO THE MEDICAL POPULATION 211
SURGICAL RESCUE IN MEDICAL PATIENTS 212
SURGICAL PATHOLOGY IN MEDICAL PATIENTS 213
A PARTNERSHIP FOR RESCUE 216
REFERENCES 217
Crisis Teams for Obstetric Patients 221
Key points 221
BACKGROUND AND JUSTIFICATION 222
DESIGN AND INTRODUCTION 223
Staff Education 226
Response Team Training 227
Recent Developments in Multidisciplinary Simulation Team Training for Obstetric Crisis 228
Data Collection, Review, and Process Improvement 229
National Initiatives for Rapid Response Teams 230
USAGE OF CONDITION O AT MAGEE-WOMEN’S HOSPITAL AND DISCUSSION 230
Continuous Quality Improvement and Evaluation of Obstetric Rapid Response Systems 233
Area of concern 1: definition of the optimal response team and the training of the team members 233
Area of concern 2: determination of the leadership of the Condition O response and the delineation of the roles of the vari ... 233
Area of concern 3: further evaluation of the triggers for a Condition O call and elimination of barriers for the calling of ... 233
Area of concern 4: establishment of an optimal debriefing process for Condition O responses and a schedule of Condition O g ... 234
Area of concern 5: establishment of robust mechanisms for patient education prior to the occurrence of a Condition O 234
Efficacy and Sustainability of Obstetric Multidisciplinary Rapid Response Systems 234
SUMMARY 235
REFERENCES 236
A Decade of Difficult Airway Response Team 239
Key points 239
INTRODUCTION 240
DIFFICULT AIRWAY RESPONSE TEAM PROGRAM: GOALS AND DESIGN 240
DIFFICULT AIRWAY RESPONSE TEAM PROGRAM: RESULTS 242
LESSONS LEARNED 243
DISCUSSION 249
REFERENCES 250
Sepsis Rapid Response Teams 253
Key points 253
BACKGROUND 253
SEPSIS RAPID RESPONSE TEAMS: WHAT ARE THEY? HOW ARE THEY DIFFERENT FROM OTHER RAPID RESPONSE TEAMS? 254
OUTCOMES AFTER IMPLEMENTATION OF SEPSIS RAPID RESPONSE TEAM/MEDICAL EMERGENCY TEAM 254
THE USE OF CLINICAL ASSESSMENT TOOLS 256
BARRIERS IN HEALTH CARE 256
REFERENCES 257
Intensivist Presence at Code Events Is Associated with High Survival and Increased Documentation Rates 259
Key points 259
INTRODUCTION 259
PROCESS 260
RESULTS 261
DISCUSSION 262
SUMMARY 265
REFERENCES 265
Fluid Therapy in the Critically Ill xiii
AMOUNT OF FLUID xiii
TYPE OF FLUID: COLLOID xiii
TYPE OF FLUID: CRYSTALLOID xiv
SUMMARY xiv
Applied Physiology of Fluid Resuscitation in Critical Illness 267
Key points 267
INTRODUCTION 267
CARDIOVASCULAR PHYSIOLOGY 101 268
Why Give Fluids? 268
Effective Circulating Blood Volume 268
Acute Cardiogenic Shock 269
Obstructive Shock 270
Hemorrhagic Shock 271
Distributive Shock 271
FLUIDS 272
CRYSTALLOIDS 273
COLLOIDS 275
SUMMARY 275
REFERENCES 276
Does Fluid Type and Amount Affect Kidney Function in Critical Illness? 279
Key points 279
INTRODUCTION 279
MEASURING RENAL DYSFUNCTION IN CRITICAL ILLNESS 280
HOW USEFUL IS URINE OUTPUT? 280
ARE FLUIDS A REQUIRED COMPONENT OF RENAL RESUSCITATION? 282
MECHANISMS OF RENAL INJURY RELATED TO TYPE OF FLUID 284
SODIUM, CHLORIDE, AND BALANCED SOLUTIONS 284
ALBUMIN SOLUTIONS 288
HYDROXYETHYL STARCH 290
GELATIN SOLUTIONS 290
SUMMARY 291
REFERENCES 292
Blood Product Administration in the Critical Care and Perioperative Settings 299
Key points 299
INTRODUCTION 299
OVERVIEW OF THE CRITICAL CARE SETTING 301
OVERVIEW OF THE PERIOPERATIVE SETTING 302
MANAGEMENT IN CRITICAL ILLNESS 302
Anemia 303
Red Blood Cell Administration 303
The Use of Plasma and Platelets 304
PERIOPERATIVE MANAGEMENT 304
Preoperative Optimization 304
Anemia 304
Risk of bleeding 305
Intraoperative Management 306
Bleeding during surgery 306
Postoperative Management 306
PERSPECTIVE 307
REFERENCES 307