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- Volume 22, Issue 1, 2006
Southern African Journal of Critical Care - Volume 22, Issue 1, 2006
Volume 22, Issue 1, 2006
Author Andrew ArgentSource: Southern African Journal of Critical Care 22 (2006)More Less
The last year has been a particularly challenging one for the critical care community. The demand for intensive care continues to grow, and it seems as if both the complexity of patient care and the expectations of patients and their families increase each year. Coupled with this has been a steady erosion of staffing levels in ICU across the country. In virtually every setting managers struggle to find staff with the skills and training required to work in ICU.
Author Mervyn MerSource: Southern African Journal of Critical Care 22, pp 4 –12 (2006)More Less
Intravascular devices are an integral component of modern-day medical practice. They are used to administer intravenous fluids, medications, blood products and parenteral nutrition. In addition they serve as a valuable monitor of the haemodynamic status of critically ill patients. Over the past 2 decades the focus of research and development in this field has been the physicochemical properties of catheters, looking at such aspects as improved catheter materials, tensile strength, rupture resistance, biocompatibility and the creation of catheter micro-environments hostile to invading organisms.
Source: Southern African Journal of Critical Care 22, pp 14 –20 (2006)More Less
Objectives. To describe the baseline data of patients admitted to the surgical intensive care unit in a tertiary hospital in the Western Cape, and their outcome at discharge from the ICU.
Design. Prospective cohort observational study.
Setting. Ten-bed closed surgical unit in a university-affiliated tertiary hospital.
Sample. One hundred and sixty consecutive adult ICU admissions from 16 June to 30 September 2003.
Measurements. Demographic information, admission diagnosis, surgery classification (elective or emergency) and co-morbidities were recorded on admission to the unit. APACHE II score was calculated. The two outcomes of ICU length of stay (LOS) and mortality were recorded on discharge from the unit.
Results. Patients were 49 ± 19.95 years of age. The mean APACHE II score was 12.3 ± 7.19 and 12.3% mortality was observed. The standardised mortality ratio was 0.87. Patients stayed in the unit for 5.94 ± 6.55 days. Hypertension was the most frequent co-morbidity found in this cohort (42%), and 21% (N = 5) of patients tested were HIV positive. Neither age, gender nor co-morbidities had any significant association with mortality or ICU LOS (p > 0.01). A significant correlation was established between APACHE II scores, mortality and ICU LOS (p < 0.001).
Conclusions. This baseline study of a surgical ICU in a tertiary environment in the Western Cape presents a picture of a unit providing care comparable to First-World environments. It is debatable whether the current admission and discharge criteria are making optimal use of the technology available in a level 1 intensive care unit. Other cost-effective ways of managing patients who are not as ill could be investigated.
Source: Southern African Journal of Critical Care 22, pp 22 –27 (2006)More Less
Objective. To analyse the performance of the Emergency Medical Rescue Service (EMRS) in North-West province.
Design. A prospective study of the activity of the EMRS.
Setting. North-West province, 2002 - 2004.
Results. During this period the EMRS response time tended to decrease (reduction of 8 minutes for rural and 6 minutes for urban areas), and the province is now within the national goals. The number of EMRS calls and patients transported increased by a monthly average of 4.8% for the first year and 4.1% for the second year. This means an increase of 357 calls and 487 patients per month. The number of first priority (P-1) (7.4 - 9.0%) and second priority (P-2) (50.2 - 51.4%) cases transported is higher; this represents a more effective service. Mortality during transport remains the same (0.2%), while mortality at the scene has increased from 0.8% to 1% of calls. Medical cases (32.8%), maternity cases (24.1%), assaults (10.6%) and motor vehicle trauma (6.0%) were the main causes of EMRS requests during the 3 years of the study.
Conclusion. Before 2003, the EMRS in North-West was one of the most undeveloped provinces in the country. The achievements (without any increase in resources) during the study period are good, and they result from changes in structure and policies, more effective control of resources, fleet management, and improvement in the medical qualification of staff.
Source: Southern African Journal of Critical Care 22, pp 28 –35 (2006)More Less
Any treatise on cardiopulmonary interactions has at its foundation a thorough understanding of both pulmonary and cardiac physiology. Although recent articles have addressed advances in the field or applications to a particular subspecialty, the reader is advised to have basic physiological articles available for a complete background. As such, the authors hope to highlight the clinical settings in which a thorough knowledge of cardiopulmonary interactions is essential to the caregiver at the bedside.
2006 Care is Critical Congress, South African Critical Care Society, Sand du Plessis Theatre, Bloemfontein, 3 - 7 September 2006 : abstractsSource: Southern African Journal of Critical Care 22, pp 36 –42 (2006)More Less
Extracted from text ... SAJCC September 2006, Vol. 22, No. 1 36 The effeCT of A pASSiVe ThorACiC flexioNroTATioN moVemeNT oN ToTAl STATiC CompliANCe of The reSpirATory SySTem ANd reSpirATory reSpoNSeS iN VeNTilATed pATieNTS Bergh A Physiotherapy Department, Tygerberg Hospital hanekom S, Bester m m Physiotherapy Department, Stellenbosch University, Western Cape, South Africa Aim: The aim of this study was to determine the effect of a passive thoracic flexion-rotation movement on the total static compliance of the respiratory system, minute ventilation, tidal volume and respiratory rate. deSiGN: This study had a one group, pre-test-post-test design. meThod: The sample consisted of 18 intubated and ventilated ..