Critical care clinics
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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.
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Critical care clinics · Jul 2023
ReviewFrom Strict Bedrest to Early Mobilization: A History of Physiotherapy in the Intensive Care Unit.
Critically ill patients are at risk of post-intensive care syndrome, including physical, cognitive, and psychological sequelae. Physiotherapists are rehabilitation experts who focus on restoring strength, physical function, and exercise capacity. ⋯ Physiotherapists are assuming more prominent roles in clinical and research leadership, with opportunities for wider interdisciplinary collaboration. This paper reviews the evolution of critical care from a rehabilitation perspective, highlights relevant research milestones, and proposes future opportunities for improving survivorship outcomes.
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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
ReviewPalliative Care in the Intensive Care Unit: Past, Present, and Future.
In this article, the authors review the origins of palliative care within the critical care context and describe the evolution of symptom management, shared decision-making, and comfort-focused care in the ICU from the 1970s to the early 2000s. The authors also review the growth of interventional studies in the past 20 years and indicate areas for future study and quality improvement for end-of-life care among the critically ill.
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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.