Critical care clinics
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Critical care clinics · Oct 2022
ReviewLiving on the Edge of Possibility: Ethical Issues in the Care of Critically Ill Patients in Resource-Limited Settings.
The birth, expansion, and sustenance of critical care medicine as a specialty have often presented ethical challenges and dilemmas to health care workers in diverse settings. In addition to critical services being provided at the extreme end of a disease process, they are often in limited supply. The authors present patterns of inception and development of this crucial service as they have witnessed in rural Africa. Furthermore, they present the ethical challenges, both typical and unique, as they have experienced them in a tertiary referral center in Kenya.
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Critical care clinics · Oct 2022
ReviewTelemedicine to Expand Access to Critical Care Around the World.
This multiauthored communication gives a state-of-the-art global perspective on the increasing adoption of tele-critical care. Exponentially increasing sophistication in the deployment of Computers, Information, and Communication Technology has ensured extending the reach of limited intensivists virtually and reaching the unreached. ⋯ Concerns and regulatory issues are being sorted out, cross-border cost-effective tele-critical care is steadily increasing Components to set up a tele-intensive care unit, and overcoming barriers is discussed. Importance of developing best practice guidelines and retraining is emphasized.
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Critical care clinics · Oct 2022
ReviewCritical Care Pandemic Preparation: Considerations and Lessons Learned from COVID-19.
Pandemics, increases in disease incidence that affect multiple regions of the world, present huge challenges to health care systems and in particular to policymakers, public health authorities, clinicians, and all health care workers (HCWs). The recent COVID-19 pandemic has resulted in millions of severely ill patients, many of whom who have required hospital and intensive care unit (ICU) admission. ⋯ Safe and effective critical care has the potential to improve outcomes, motivate individuals to seek timely medical attention, and attenuate the devastating sequelae of a severe pandemic. To achieve this, suitable critical care planning and preparation are essential.
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Critical care clinics · Oct 2022
ReviewThe Next Frontier in Neurocritical Care in Resource-Constrained Settings.
Neurocritical care (NCC) is an emerging field within critical care medicine, reflecting the widespread prevalence of neurologic injury in critically ill patients. Morbidity and mortality from neurocritical illness (NCI) have been reduced substantially in resource-rich settings (RRS), owing to the development of advanced technologies, neuro-specific units, and subspecialized medical training. Despite shouldering much of the burden of NCI worldwide, resource-limited settings (RLS) face immense hurdles when implementing guidelines generated in RRS. This review summarizes the current epidemiology, management, and outcomes of the most common NCIs in RLS and offers commentary on future directions in NCC practiced in RLS.
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Critical care clinics · Oct 2022
ReviewThe State of Global Trauma and Acute Care Surgery/Surgical Critical Care.
Trauma is a leading cause of morbidity and mortality globally, with a significant burden attributable to the low- and middle-income countries (LMICs), where more than 90% of injury-related deaths occur. Road injuries contribute largely to the economic burden from trauma and are prevalent among adolescents and young adults. Trauma systems vary widely across the world in their capacity of providing basic and critical care to injured patients, with delays in treatment being present at multiple levels at LMICs. Strengthening existing systems by providing cost-effective and efficient solutions can help mitigate the injury burden in LMICs.