Developing the Synergy Model Patient Acuity Tool for Admission, Discharge, and Transfer.

Background: The Admission Discharge Transfer-Synergy Model Acuity Tool (ADT-SMAT) was developed to quantify patient intervention intensity and patient response variability and to capture nurses' critical thinking. The tool is based on the American Association of Critical-Care Nurses Synergy Model for Patient Care.

Objective: To determine whether the ADT-SMAT is reliable and valid for predicting the level of care for admission, discharge, and transfer of critically ill patients.

Prehospital hypocapnia and poor outcome after severe traumatic brain injury.

Background: The Brain Trauma Foundation (BTF) Guidelines for prehospital management of traumatic brain injury (TBI) recommend a goal end-tidal carbon dioxide of 30 mm Hg to 35 mm Hg in patients without signs of herniation.

Methods: We examined prehospital concordance with BTF Guidelines, selected demographic and physiologic variables and outcomes for 100 consecutive admissions to a well-established Level I regional trauma center. All patients had blunt TBI with Glasgow Coma Score < or = 8 without signs of herniation.