Critical care clinics
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The use of ultrasonography in medical practice has evolved dramatically over the last few decades and will continue to improve as technological advances are incorporated into daily medical practice. Although ultrasound machine size and equipment have evolved, the basic principles and fundamental functions have remained essentially the same. This article reviews the general ultrasound apparatus design, the most common probe types available, and the system controls used to manipulate the images obtained. Becoming familiar with the machine and the controls used for image generation optimizes the scans being performed and enhances the use of ultrasound in patient care.
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Critically ill patients require rapid, accurate assessments and appropriate therapeutic interventions to maximize their chances of recovery. Often the cause of a patient's decompensation is not readily apparent based solely on history and physical examination findings. The Concentrated Overview of Resuscitative Efforts (CORE scan) is a compilation of targeted bedside ultrasound exams that should be performed during the assessment and management of critically ill patients. The CORE scan can be used to help make critical diagnoses and guide resuscitation efforts in patients with undifferentiated deterioration.
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Critical care clinics · Oct 2013
ReviewPrevention, Diagnosis, and Management of Surgical Site Infections: Relevant Considerations for Critical Care Medicine.
Surgical site infection complicates 2% to 5% of all operative procedures. Many of the risk factors for the development of a surgical site infection (eg, old age, major comorbidity, emergency surgery) are present in patients typically requiring postoperative admission to the intensive care unit. This article reviews the risk factors and measures to prevent surgical site infection and diagnostic and management considerations relevant to critical care medicine.
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Severe malaria is a medical emergency requiring early intervention to prevent death. This article highlights key aspects of the management of severe malaria syndromes in the intensive care unit, with a focus on individual case management of imported malaria. ⋯ In all groups with severe malaria, intravenous artesunate is the antimalarial agent of choice. This article discusses specific antimalarial therapies, optimal supportive management strategies, differences from strategies for bacterial sepsis, and trials of adjunctive therapy for severe malaria in humans.
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Critical care clinics · Oct 2013
ReviewOther Viral Pneumonias: Coronavirus, Respiratory Syncytial Virus, Adenovirus, Hantavirus.
Severe viral pneumonia is an increasing problem among adults. The incidence and number of viruses known to cause pneumonia and respiratory failure have also expanded in recent years. ⋯ Management of individual cases is mainly supportive and requires institution of appropriate infection control measures. Vaccines and effective therapeutics for these potentially devastating respiratory viruses are urgently required.