Objectives: To prepare for the predicted surge of patients with COVID-19 in Southeast Michigan, the US Department of Veterans Affairs Ann Arbor Healthcare System engineered, built, and staffed a 12-bed intensive care unit (ICU) from the existing postanesthesia care unit (PACU).
Observations: Considerations including floor planning, reversal of airflow, strict airborne precautions, sealing off a dedicated nursing station, and developing an infection control plan in an open care unit. A staffing model was created that included anesthesiologist intensivists, advanced practice providers, residents, certified registered nurse anesthetists, and perioperative nurses working alongside ICU trained nurses. Challenges arose in infection control, communication, mechanical ventilation using anesthesia machines, providing renal replacement therapy, and maintaining patient privacy in an open unit.
Conclusions: This article describes the setup, challenges, and solutions that allowed the creation of the PACU-ICU to help serve veterans and civilians during a time of unprecedented strain on the health care system due to COVID-19.
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http://dx.doi.org/10.12788/fp.0020 | DOI Listing |
Med J Aust
January 2025
Juno Healthcare, Melbourne, VIC.
Int J Equity Health
January 2025
Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Background: Predicting burn-related mortality is vital for family counseling, triage, and resource allocation. Several of the burn-specific mortality prediction scores have been developed, including the Abbreviated Burn Severity Index (ABSI) in 1982. However, these scores are not tested for accuracy to support contemporary estimates of the global burden of burn injury.
View Article and Find Full Text PDFCrit Care
January 2025
LNC UMR1231, University of Burgundy and Franche-Comté, 21000, Dijon, France.
Background: Pulse pressure variation (PPV) is limited in low tidal volume mechanical ventilation. We conducted this systematic review and meta-analysis to evaluate whether passive leg raising (PLR)-induced changes in PPV can reliably predict preload/fluid responsiveness in mechanically ventilated patients with low tidal volume in the intensive care unit.
Methods: PubMed, Embase, and Cochrane databases were screened for diagnostic research relevant to the predictability of PPV change after PLR in low-tidal volume mechanically ventilated patients.
Crit Care
January 2025
Department of Pediatric, West China Second University Hospital, Sichuan University, Chengdu, China.
Background: Patients supported by extracorporeal membrane oxygenation (ECMO) are at a high risk of brain injury, contributing to significant morbidity and mortality. This study aimed to employ machine learning (ML) techniques to predict brain injury in pediatric patients ECMO and identify key variables for future research.
Methods: Data from pediatric patients undergoing ECMO were collected from the Chinese Society of Extracorporeal Life Support (CSECLS) registry database and local hospitals.
Int J Equity Health
January 2025
Tekano, Capetown, South Africa.
Globally, individuals with Down syndrome (DS) face profound inequities in social and health care access. These challenges are further compounded by racial disparities as well as a lack of awareness, research, and support, particularly in the Global South. This commentary discusses the multifaceted challenges and disparities encountered by people with DS in South Africa, highlighting the need for targeted interventions.
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