MEDBOX | Toolbox Intensive Care Unit

How an ICU works to prevent or treat hospital-acquired infections

Pan American Health Organisation PAHO (2021) C_WHO

Did you know that they are part of Antimicrobial Resistance? Are you clear that we can all do something to avoid them? Marcelo Barbato, intensive care physician and Director of the ICU at Hospital Maciel, the first public hospital in Uruguay with a long history in infection control, tells us

Tags: Video, AMR, Antimicrobial resistance, prevention policies, hospitals, ICU, ICU management,

Source: https://youtu.be/9iy3ePq3xSM

Facilitating high quality acute care in resource- constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi

Limbani, F.; O. Kabajaasi, M. Basemera, et al. (2022) CC

PLOS Glob Public Health 2(8): e0000272. https://doi.org/10.1371/journal.pgph.0000272 Sepsis is a major global health problem, especially in sub-Saharan Africa. Improving patient care requires that healthcare providers understand patients’ priorities and provide quality care within the confines of the context they work. We report the perspectives of patients, caregivers and healthcare workers regarding care quality for patients admitted for sepsis to public hospitals in Uganda and Malawi. This qualitative descriptive study in two hospitals included face-to face semi-structured interviews with purposively selected patients recovering from sepsis, their caregivers and healthcare workers. In both Malawi and Uganda, sepsis care often occurred in resource-constrained environments which undermined healthcare workers’ capacity to deliver safe, consistent and accessible care. Constraints included limited space, strained; water, sanitation and hygiene (WASH) amenities and practices, inadequate human and material resources and inadequate provision for basic needs including nutrition. Heavy workloads for healthcare workers strained relationships, led to poor communication and reduced engagement with patients and caregivers

Tags: sepsis, Uganda, Malawi, caregivers, healthworkers, care, quality of care, hospitals, workload, patient safety,

Source: https://journals.plos.org/globalpubliche

World Health Organization WHO (2022) C_WHO

For patients on HFNO with persistent hypoxaemia or respiratory distress: • Check the equipment: inspect the exterior of the machine, the tubing (circuit), the prong for any sign of mechanical damage, confirm it fits and the filters are in place. Ensure the settings are appropriate and flow is maximized. • Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the device must have a blender. • Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration

Tags: critical care, oxygen sources, oxygen therapy, hypoxaemia, Respiratory Disorders, COVID-19, critically ill, ICU, Ventilation,

Source: https://www.who.int/docs/default-source/

World Health Organization WHO (2022) C_WHO

WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support. Hypoxaemic respiratory failure in ARDS commonly results from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation. At any time, if there are urgent or emergent indications for intubation, do not delay. WHO suggests that hospitalized patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) rather than standard oxygen therapy

Tags: critical care, oxygen sources, oxygen therapy, hypoxaemia, Respiratory Disorders, COVID-19, critically ill, ICU, Ventilation,

Source: https://www.who.int/docs/default-source/

World Health Organization WHO (2022) C_WHO

WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support. Hypoxaemic respiratory failure in ARDS commonly results from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation. At any time, if there are urgent or emergent indications for intubation, do not delay. We recommend prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support. WHO suggests that patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) over standard oxygen therapy

Tags: critical care, oxygen sources, oxygen therapy, hypoxaemia, Respiratory Disorders, COVID-19, critically ill, ICU, Ventilation,

Source: https://www.who.int/docs/default-source/

World Health Organization WHO (2022) C_WHO

For patients on NIPPV or HFNO with persistent hypoxaemia or respiratory distress: • Check the equipment: inspect the exterior of the machine, the tubing (circuit), the mask for any sign of mechanical damage, confirm it fits securely without leak (if CPAP/BiPAP) and the filters are in place. Ensure the settings are appropriate and flow is maximized. • Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the ventilator must have a blender. • Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration

Tags: critical care, oxygen sources, oxygen therapy, hypoxaemia, Respiratory Disorders, COVID-19, critically ill, ICU, Ventilation,

Source: https://www.who.int/docs/default-source/

Essential Emergency and Critical Care: a consensus among global clinical experts

Schell, C.O.; K. Khalid, A.Wharton-Smith, et al. (2021) CC

Key questions What is already known? Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients. There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortality rates are high. Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world. What are the new findings? The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide. The resource requirements for hospitals to be ready to provide this care has been described. What do the new findings imply? The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths. Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening

Tags: critical care, critically ill, EECC, essential emergency and critical care, quality of care, intensive care nursing, intensive care, essential care, low-cost settings,

Source: https://gh.bmj.com/content/6/9/e006585

Major trauma backpack 2021

World Health Organization WHO (2021) C_WHO

The WHO Trauma Bag 2021 is intended to provide the resources needed to care for care of acutely ill and injured patients in hospital emergency units, field hospitals or clinics providing acute care. The Trauma Bag may also be applicable in prehospital settings if care is provided by advanced practitioners. The bag allows users to access essential equipment in one location and is organized into removable color-coded pouches according to the clinical indication. The composition of the bag was determined by broad consensus among diverse emergency care stakeholders. The new trauma bag is designed for trained medical doctors & first responders. The majority of the included supply can be used by trained first responders. A dedicated intubation module should only be handled by trained providers acting within their scope of practice. The WHO Trauma Bag aims to provide materials to meet the needs of 2 adults and 2 children requiring trauma car

Tags: Trauma, emergency aid, prehospital, acute care, first responder, intubation, Trauma Care,

Source: https://www.who.int/emergencies/emergenc

Essential critical care skills 1: what is critical care nursing?

Credland, N.; et al. (2021) C2

Nursing Times [online]; 117: 11, 18-21.

Tags: critical care, nursing, nursing care, skills,

Source: https://cdn.ps.emap.com/wp-content/uploa

Competencies for critical care nurse specialist (Adult)

South African Nursing Council (2020) CC

Tags: national policy, nurses, Training, Standards,

Source: https://www.sanc.co.za/wp-content/upload

	How an ICU works to prevent or treat hospital-acquired infections Pan American Health Organisation PAHO (2021) C_WHO Open external link (71) Add to my MEDBOX Did you know that they are part of Antimicrobial Resistance? Are you clear that we can all do something to avoid them? Marcelo Barbato, intensive care physician and Director of the ICU at Hospital Maciel, the first public hospital in Uruguay with a long history in infection control, tells us Tags: Video, AMR, Antimicrobial resistance, prevention policies, hospitals, ICU, ICU management, Source: https://youtu.be/9iy3ePq3xSM
	Facilitating high quality acute care in resource- constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi Limbani, F.; O. Kabajaasi, M. Basemera, et al. (2022) CC Open external link (59) Add to my MEDBOX PLOS Glob Public Health 2(8): e0000272. https://doi.org/10.1371/journal.pgph.0000272 Sepsis is a major global health problem, especially in sub-Saharan Africa. Improving patient care requires that healthcare providers understand patients’ priorities and provide quality care within the confines of the context they work. We report the perspectives of patients, caregivers and healthcare workers regarding care quality for patients admitted for sepsis to public hospitals in Uganda and Malawi. This qualitative descriptive study in two hospitals included face-to face semi-structured interviews with purposively selected patients recovering from sepsis, their caregivers and healthcare workers. In both Malawi and Uganda, sepsis care often occurred in resource-constrained environments which undermined healthcare workers’ capacity to deliver safe, consistent and accessible care. Constraints included limited space, strained; water, sanitation and hygiene (WASH) amenities and practices, inadequate human and material resources and inadequate provision for basic needs including nutrition. Heavy workloads for healthcare workers strained relationships, led to poor communication and reduced engagement with patients and caregivers Tags: sepsis, Uganda, Malawi, caregivers, healthworkers, care, quality of care, hospitals, workload, patient safety, Source: https://journals.plos.org/globalpubliche
	Management of critical COVID-19 Advanced non-invasive respiratory support: high-flow nasal oxygen and non-invasive ventilation- Part 2: NIPPV High-flow nasal oxygen (HFNO) World Health Organization WHO (2022) C_WHO View PDF(26) Download (11) Add to my MEDBOX For patients on HFNO with persistent hypoxaemia or respiratory distress: • Check the equipment: inspect the exterior of the machine, the tubing (circuit), the prong for any sign of mechanical damage, confirm it fits and the filters are in place. Ensure the settings are appropriate and flow is maximized. • Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the device must have a blender. • Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration Tags: critical care, oxygen sources, oxygen therapy, hypoxaemia, Respiratory Disorders, COVID-19, critically ill, ICU, Ventilation, Source: https://www.who.int/docs/default-source/
	Management of critical COVID-19 Advanced non-invasive respiratory support: high-flow nasal oxygen and non-invasive ventilation- Part 1: Characteristics of NIV World Health Organization WHO (2022) C_WHO View PDF(33) Download (12) Add to my MEDBOX WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support. Hypoxaemic respiratory failure in ARDS commonly results from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation. At any time, if there are urgent or emergent indications for intubation, do not delay. WHO suggests that hospitalized patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) rather than standard oxygen therapy Tags: critical care, oxygen sources, oxygen therapy, hypoxaemia, Respiratory Disorders, COVID-19, critically ill, ICU, Ventilation, Source: https://www.who.int/docs/default-source/
	Management of critical COVID-19: Acute hypoxaemic respiratory failure and COVID-19: Recognize ARDS World Health Organization WHO (2022) C_WHO View PDF(31) Download (54) Add to my MEDBOX WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support. Hypoxaemic respiratory failure in ARDS commonly results from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation. At any time, if there are urgent or emergent indications for intubation, do not delay. We recommend prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support. WHO suggests that patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) over standard oxygen therapy Tags: critical care, oxygen sources, oxygen therapy, hypoxaemia, Respiratory Disorders, COVID-19, critically ill, ICU, Ventilation, Source: https://www.who.int/docs/default-source/
	Management of critical COVID-19 Advanced non-invasive respiratory support: high-flow nasal oxygen and non-invasive ventilation -Part 3: NIPPV (CPAP and BiPAP) World Health Organization WHO (2022) C_WHO View PDF(32) Download (12) Add to my MEDBOX For patients on NIPPV or HFNO with persistent hypoxaemia or respiratory distress: • Check the equipment: inspect the exterior of the machine, the tubing (circuit), the mask for any sign of mechanical damage, confirm it fits securely without leak (if CPAP/BiPAP) and the filters are in place. Ensure the settings are appropriate and flow is maximized. • Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the ventilator must have a blender. • Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration Tags: critical care, oxygen sources, oxygen therapy, hypoxaemia, Respiratory Disorders, COVID-19, critically ill, ICU, Ventilation, Source: https://www.who.int/docs/default-source/
	Essential Emergency and Critical Care: a consensus among global clinical experts Schell, C.O.; K. Khalid, A.Wharton-Smith, et al. (2021) CC Open external link (473) Add to my MEDBOX Key questions What is already known? Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients. There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortality rates are high. Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world. What are the new findings? The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide. The resource requirements for hospitals to be ready to provide this care has been described. What do the new findings imply? The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths. Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening Tags: critical care, critically ill, EECC, essential emergency and critical care, quality of care, intensive care nursing, intensive care, essential care, low-cost settings, Source: https://gh.bmj.com/content/6/9/e006585
	Major trauma backpack 2021 World Health Organization WHO (2021) C_WHO Open external link (322) Add to my MEDBOX The WHO Trauma Bag 2021 is intended to provide the resources needed to care for care of acutely ill and injured patients in hospital emergency units, field hospitals or clinics providing acute care. The Trauma Bag may also be applicable in prehospital settings if care is provided by advanced practitioners. The bag allows users to access essential equipment in one location and is organized into removable color-coded pouches according to the clinical indication. The composition of the bag was determined by broad consensus among diverse emergency care stakeholders. The new trauma bag is designed for trained medical doctors & first responders. The majority of the included supply can be used by trained first responders. A dedicated intubation module should only be handled by trained providers acting within their scope of practice. The WHO Trauma Bag aims to provide materials to meet the needs of 2 adults and 2 children requiring trauma car Tags: Trauma, emergency aid, prehospital, acute care, first responder, intubation, Trauma Care, Source: https://www.who.int/emergencies/emergenc
	Essential critical care skills 1: what is critical care nursing? Credland, N.; et al. (2021) C2 View PDF(44) Download (18) Add to my MEDBOX Nursing Times [online]; 117: 11, 18-21. Tags: critical care, nursing, nursing care, skills, Source: https://cdn.ps.emap.com/wp-content/uploa
	Competencies for critical care nurse specialist (Adult) South African Nursing Council (2020) CC View PDF(50) Download (20) Add to my MEDBOX Tags: national policy, nurses, Training, Standards, Source: https://www.sanc.co.za/wp-content/upload