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Pre-ICU

What happens before patients arrive in the ICU? We know that status pre-ICU is associated with outcomes after patients leave the ICU. We also know that we want patients to come to the ICU only if it is needed. This ties in to having an adequate emergency medicine system and innovative technique

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Rapid response teams

This article reviews the RRT system concept and provides an update on the current state of such systems, their challenges, their performance, the evidence supporting their usefulness and their evolution. Rapid Response Teams (RRTs) are the key components of Rapid Response Systems. RRT-

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Is pre-hospital coagulation management in trauma feasible?

Coagulation management remains a formidable challenge in severely bleeding trauma patients. A strong rationale suggests starting treatment of trauma-induced coagulopathy in the pre-hospital phase. The burden of trauma is increasing worldwide, particularly in less well-resourced nations. Th

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Pre-ICU health organisation in Norway

Presents the main principles of the Norwegian acute healthcare system. Norway is a rather small country with a population of about 5.3 million. More than half of these inhabitants are located in and around the larger cities, with about a million in the capital region of Oslo. Hence, signi

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Emergency pre-hospital care challenges: Greece

The ongoing economic crisis in Greece and inflow of refugees has led to changes to the pre-hospital emergency medicine services. Greece is a country of 10.1 million inhabitants, half of whom live in six cities: Athens, Thessaloniki, Heraklion, Patra, Larissa and Ioannina. In recent years

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The Accelerate Pheno™ system in clinical practice: fast and accurate turnaround for critical results

Our clinical experiences of using the Accelerate Pheno™ system have greatly benefited patient care, providing earlier diagnostic certainty. Two complex sepsis cases are discussed, where the impact of rapid identification, with antibiotic sensitivities, of the causative organism from blood culture

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Point-of care ultrasonography in critical care

A brief overview of point-of-care ultrasound (POCUS) in the ICU: for the already converted, a reminder of how POCUS has changed ICU practice; for the ultrasound naïve, an aperitif to leave the reader with interest in this evolving paradigm shift of patient care. As intensivists, we ha

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Management of bleeding in visceral surgery and liver transplantation

The implementation of patient blood management programmes led to reduced blood product usage. However, haemorrhage secondary to major surgery remains a major cause of potentially preventable death. Considering the heterogeneity of procedures and technical approaches, it is not surprising that the

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Liver support in the intensive care unit: mechanism of action and science

The idea of liver assist is extremely attractive for patients with liver failure, as the liver possesses huge capacity to regenerate. The hypothesis behind the use of extracorporeal liver assist is to enhance the regenerative environment by removing or replacing toxic molecules while the liver ca

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Immediate-type hypersensitivity reactions in the ICU

For the ICU patient, correct and timely diagnosis of drug hypersensitivity is required to administer emergency epinephrine treatment, and retrospective allergological investigation is needed to identify the culprit drug and safe alternatives. For ICU departments, epidemiological data regarding th

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