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Extra resources for ABC of Intensive Care - [unkn]
A systematic review of the literature is underway. Kevin Gunning is consultant in anaesthesia and intensive care, John Farman Intensive Care Unit, Addenbrooke’s Hospital, Cambridge, and Kathy Rowan is scientific director, Intensive Care National Audit Research Centre, London. The ABC of intensive care is edited by Mervyn Singer, reader in intensive care medicine, Bloomsbury Institute of Intensive Care Medicine, University College London, and Ian Grant, director of intensive care, Western General Hospital, Edinburgh.
All those assisting in the transfer should know where the equipment is and be familiar with using the equipment and drugs. If patients are transferred on standard ambulance trolleys equipment has to be carried by hand or laid on top of the patient, which is unsatisfactory. Special trolleys should be used that allow items to be secured to a pole or shelf above or below the patient. Portable ventilator, battery powered syringe pumps, and monitor Accompanying staff In addition to the vehicle’s crew, a critically ill patient should be accompanied by a minimum of two attendants.
Families who feel excluded from discussion, who have had the burden of decision making placed on them, or in cases where there was delay or excess haste in enacting decisions express negative feelings towards the process of withdrawing treatment. Communication with the family is a vital part of the general care of intensive care patients. Relatives must be kept fully informed about the patient’s condition, in particular regarding issues of limiting and withdrawing treatment. Although decisions rest with the medical staff, it is unwise to limit or withdraw treatment without the agreement of the relatives.