Critical care clinics
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Critical care pharmacy has evolved rapidly over the last 50 years to keep pace with the rapid technological and knowledge advances that have characterized critical care medicine. The modern-day critical care pharmacist is a highly trained individual well suited for the interprofessional team-based care that critical illness necessitates. Critical care pharmacists improve patient-centered outcomes and reduce health care costs through three domains: direct patient care, indirect patient care, and professional service. Optimizing workload of critical care pharmacists, similar to the professions of medicine and nursing, is a key next step for using evidence-based medicine to improve patient-centered outcomes.
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Critical care clinics · Jul 2023
ReviewFour Decades of Intensive Care Unit Design Evolution and Thoughts for the Future.
Intensive care unit (ICU) design has changed since the mid-1980s. Targeting timing and incorporation of the dynamic and evolutionary processes inherent in ICU design is not possible nationally. ICU design will continue evolving to incorporate new concepts of best design evidence and practice, better understandings of the needs of patients, visitors and staff, unremitting advances in diagnostic and therapeutic approaches, ICU technologies and informatics, and the ongoing search to best fit ICUs within greater hospital complexes. As the ideal ICU remains a moving target; the design process should include the ability for an ICU to evolve into the future.
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A large variety of airway devices, techniques, and cognitive tools have been developed during the last 100 years to improve airway management safety and became a topic of major research interest. This article reviews the main developments in this period, starting with modern day laryngoscopy in the 1940s, fiberoptic laryngoscopy in the 1960s, supraglottic airway devices in the 1980s, algorithms for difficult airway in the 1990s, and finally modern video-laryngoscopy in the 2000s.
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Critical care clinics · Jul 2023
ReviewCritical Care 1950 to 2022: Evolution of Medicine, Nursing, Technology, and Design.
Critical care units-designed for concentrated and specialized care-came from multiple parallel advances in medical, surgical, and nursing techniques and training taking advantage of new therapeutic technologies. Regulatory requirements and government policy impacted design and practice. ⋯ Hospitals offered newer, more extreme, and specialized surgeries and anesthesia enabled more complex procedures. ICUs developed in the 1950s, providing a recovery room's level of observation and specialized nursing to serve the critically ill, whether medical or surgical.
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The first ICU in Toronto was opened at the Toronto General Hospital as a "Respiratory Unit" in 1958. The early days of this unit have been described in various articles published at the time, such as a description in the Canadian Medical Assn. Journal of the establishment of the Unit itself, including the 4 sine qua nons for intensive care. This article will focus particularly on some of the significant issues that arose in the initial years between the opening of the unit in 1958 and the arrival of clinically available blood gas measurement in the early 1960s.