Electronic medical record in the intensive care unit.

Abstract:

:The EMR in the ICU has the utility of providing the necessary information to make sound clinical decisions for critically ill patients. For it to be optimized, the EMR must be more than just what is being replicated in the written record or merely a documentation tool; it must add value that supports and enhances clinical decision support. The EMR is too expensive a tool just to be a computer designed to ease documentation and retrieve data faster. Gardner and Huff have suggested that the EMR must answer three questions: Why, What, and So What. The "Why" is relatively easy to answer, but the "What" data to use so that the information is meaningful to a provider and the "So What" are more difficult to answer. Provided one can qualitatively assess "What" information is important for a health care provider, then "So What" becomes an important objective in the empirical quantification of the benefits that the EMR provides. It is clear that to analyze some of the outcomes that health care delivery provides, one needs some mechanism to automate the information at the point of care, particularly now that the regulatory agencies are requiring it. Given the fact that there is no single integrated computerized patient record, this becomes the daunting task for the next century. Making it easier for health care providers to interact with the system and providing them with instantaneous feedback that changes their medical decision so they can deliver better care (clinical pathways, clinical practice guidelines) will be the task required of the next generation of CISs.

journal_name

Crit Care Clin

journal_title

Critical care clinics

authors

Sado AS

doi

10.1016/s0749-0704(05)70068-3

subject

Has Abstract

pub_date

1999-07-01 00:00:00

pages

499-522

issue

3

eissn

0749-0704

issn

1557-8232

pii

S0749-0704(05)70068-3

journal_volume

15

pub_type

杂志文章,评审
  • Physiology of mechanical ventilation.

    abstract::Mechanical ventilation, although essential in taking care of acute lung injury and widely used during surgical procedures worldwide, remains a highly debated field. Clinical trials in the last decade have shown convincingly that mechanical ventilation can result in additional mortality in patients with acute lung inju...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2006.11.016

    authors: Haitsma JJ

    更新日期:2007-04-01 00:00:00

  • History, general overview, and protection of health care workers.

    abstract::This article provides a background so that the intensivist can appreciate the social and cultural context in which the AIDS epidemic developed. The upheaval that AIDS has caused in the gay community is described along with some of the economic effects AIDS has had on that population and on the practice of medicine, bo...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Greenbaum DM

    更新日期:1993-01-01 00:00:00

  • Psychiatric Aspects of Organ Transplantation in Critical Care: An Update.

    abstract::Transplant patients face challenging medical journeys, with many detours to the intensive care unit. Before and after transplantation, they have significant psychological and cognitive comorbidities, which decrease their quality of life and potentially compromise their medical outcomes. Critical care staff are essenti...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2017.03.009

    authors: Sher Y,Zimbrean P

    更新日期:2017-07-01 00:00:00

  • Hypocalcemia and hypophosphatemia in acutely ill patients.

    abstract::Hypocalcemia and hypophosphatemia have recently been recognized as common metabolic complications in acutely ill patients. The diagnostic and therapeutic approaches to these abnormalities are described in this article. ...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Desai TK,Carlson RW,Geheb MA

    更新日期:1987-10-01 00:00:00

  • Strategies for managing perioperative hypertension.

    abstract::Hypertension is a pervasive and growing health concern. The occurrence of hypertension due to systemic vasoconstriction in patients before, during, and after surgery is not uncommon and can have serious consequences with regard to outcomes. Careful evaluation prior to surgery to identify the underlying cause of hypert...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Goldberg ME,Weaver FA

    更新日期:2007-10-01 00:00:00

  • Hypertensive crisis.

    abstract::Hypertensive crisis is an acute emergency requiring aggressive management. Its incidence has decreased in recent years but still is prevalent in the medical community. From review of past and present treatment regimens, the following recommendations can be considered. (1) In the treatment of malignant hypertension wit...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Rubenstein EB,Escalante C

    更新日期:1989-07-01 00:00:00

  • Biowarfare and bioterrorism.

    abstract::Bioterrorism is not only a reality of the times in which we live but bioweapons have been used for centuries. Critical care physicians play a major role in the recognition of and response to a bioterrorism attack. Critical care clinicians must be familiar with the diagnosis and management of the most likely bioterrori...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2013.03.015

    authors: Christian MD

    更新日期:2013-07-01 00:00:00

  • Satisfaction in Intensive Care Unit Telemedicine Programs.

    abstract::For well over a decade, intensive care unit (ICU) telemedicine programs have been providing care to patients and families and an invaluable service to many receiving sites that are otherwise outside the traditional reach of high-quality critical care. It will be important that during this growth, outcomes regarding th...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2019.02.006

    authors: Johnson AB

    更新日期:2019-07-01 00:00:00

  • Chemical Agents in Disaster: Care and Management in the Intensive Care Unit.

    abstract::Chemical agents of warfare are divided into lung agents, blood agents, vesicants, and nerve agents. Intensivists must familiarize themselves with the clinical presentation and management principles in the event of a chemical attack. Key principles in management include aggressive supportive care and early administrati...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2019.05.002

    authors: Mishra R,Geiling J

    更新日期:2019-10-01 00:00:00

  • Epidemiology and incidence: the scope of the problem and risk factors for development of venous thromboembolism.

    abstract::The proportion of hospitalized patients with pulmonary embolism (PE) is increasing. Whether this represents more admissions with PE or more diagnoses made in hospitalized patients is uncertain. The proportion of hospitalized patients with deep venous thrombosis has decreased precipitously as a result of home treatment...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2011.09.006

    authors: Stein PD,Matta F

    更新日期:2011-10-01 00:00:00

  • The overlap syndrome: chronic obstructive pulmonary disease and obstructive sleep apnea.

    abstract::The overlap syndrome defines the relationship between obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), and is a commonly noted but poorly studied disorder. Individuals who have the overlap syndrome have been recognized to have greater risk for pulmonary hypertension, right heart failure,...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2008.02.005

    authors: Hiestand D,Phillips B

    更新日期:2008-07-01 00:00:00

  • Cardiac disease in pregnancy.

    abstract::The pregnant patient with normal cardiac function can accommodate many significant alterations in the cardiovascular system without difficulty. Pregnancy in a patient with significant cardiac disease, however, can be extremely hazardous, resulting in decompensation and even death. these conditions account for up to 30...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Clark SL

    更新日期:1991-10-01 00:00:00

  • Trauma anesthesia and critical care: the concept and rationale for a new subspecialty.

    abstract::Proper care of the severely injured patient will require the development of a new anesthesia specialist. The trauma anesthesiologist, like the cardiovascular anesthesiologist, must become thoroughly familiar with one disease. The anesthesiologist who manages patients with traumatic disease must become an expert in cri...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Grande CM,Stene JK,Bernhard WN,Barton CR

    更新日期:1990-01-01 00:00:00

  • Antibiotic selection for patients with septic shock.

    abstract::Early recognition of the sepsis syndrome, prompt administration of broad-spectrum antibiotics, surgical intervention when indicated, and aggressive supportive care in intensive care units remain the therapeutic strategies for patients with sepsis. Antibiotic selection is based on many factors including the most probab...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0749-0704(05)70108-1

    authors: Simon D,Trenholme G

    更新日期:2000-04-01 00:00:00

  • Therapeutic strategies for acute hypoxemic respiratory failure.

    abstract::Acute hypoxemic respiratory failure is a pulmonary capillary leak state that occurs in many different clinical settings. The resultant edema causes refractory hypoxemia due to intrapulmonary shunting and loss of lung compliance. Mechanical ventilation with PEEP and high concentrations of supplemental oxygen are freque...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Zucker AR

    更新日期:1988-10-01 00:00:00

  • Management of spinal cord injury in the critical care setting.

    abstract::Approximately 12,000 Americans suffer traumatic spinal cord injuries each year. This article discusses the management of their neurologic, respiratory, cardiovascular, gastroenterologic, and genitourinary complications in the critical care setting. ...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: McVicar JP,Luce JM

    更新日期:1986-10-01 00:00:00

  • Receptor physiology: clinical implications.

    abstract::As scientists and physicians have gained sophistication in understanding and treating illness, our view of disease has changed in scope. We appreciate more fully the diverse and wide-ranging effects of stress on the ability of the organism to maintain homeostasis. As our study of the failure of homeostasis has advance...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Weise KL

    更新日期:1988-10-01 00:00:00

  • Hemoglobin A1c and Permissive Hyperglycemia in Patients in the Intensive Care Unit with Diabetes.

    abstract::Glycated hemoglobin A1c can be used to assess intensive care unit patients' level of chronic glycemic control. Compared with patients with normal glycated hemoglobin A1c, patients with elevated glycated hemoglobin A1c seem to better tolerate hyperglycemia and large glucose fluctuations during critical illness. The ris...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2018.11.010

    authors: Balintescu A,Mårtensson J

    更新日期:2019-04-01 00:00:00

  • Epidemiology and natural history of acute renal failure in the ICU.

    abstract::This article focuses on the incidence, risk factors, and mortality of acute renal failure (ARF) in critically ill patients. Accurate epidemiologic assessment of ARF is still a problem; as long as there is neither a uniquely accepted definition of ARF nor definitions for end points to measure, results will remain heter...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2004.12.005

    authors: Joannidis M,Metnitz PG

    更新日期:2005-04-01 00:00:00

  • Nosocomial diarrhea.

    abstract::Nosocomial diarrheas are an important problem in hospitals, and in critical care units in particular. Hospital-acquired diarrhea may be on an infectious or noninfectious basis. Common noninfectious causes of nosocomial diarrhea include medication-induced changes in the fecal flora or changes secondary to enteral hyper...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0749-0704(05)70398-5

    authors: Cunha BA

    更新日期:1998-04-01 00:00:00

  • Mechanisms of cerebral injury from cardiac surgery.

    abstract::Cerebral injury is a frequent complication of cardiac surgery, and it has been associated with high mortality, morbidity, hospital costs; an increased likelihood of admission to a secondary care facility after hospital discharge; and impaired quality of life. This article examines postulated mechanisms for cerebral in...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2007.09.004

    authors: Hogue CW,Gottesman RF,Stearns J

    更新日期:2008-01-01 00:00:00

  • Neurologic pain syndromes in patients with cancer.

    abstract::One third of cancer patients in active therapy and two thirds of patients with far-advanced disease have significant pain. A series of specific neurologic pain syndromes occur in this population and are unique to this pain population. Early diagnosis and treatment are critical to prevent irreversible neurologic damage...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Elliott K,Foley KM

    更新日期:1990-04-01 00:00:00

  • Natural disasters.

    abstract::This article presents the health effects of some of the more important acute natural disasters and outlines requirements for effective medical response to these events (table 7). In summary, although all disasters are unique in that they affect regions of the world with differing social, economic, and health backgroun...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Noji EK

    更新日期:1991-04-01 00:00:00

  • Neuroendovascular rescue. Nonthrombolytic approach to acute brain ischemia.

    abstract::The field of neuroendovascular therapy is rapidly growing. New technology and operators' expertise is developing at a pace that will make this discipline progressively more available and successful. For the intensive care of patients who have acute brain ischemia, new techniques of recanalizing occluded arteries are p...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0749-0704(05)70086-5

    authors: Gomez CR,Wadlington VR,Terry JB,Tulyapronchote R

    更新日期:1999-10-01 00:00:00

  • Vesicants.

    abstract::Vesicants (or blister agents) are cytotoxic alkylating compounds, which are chemical agents sometimes collectively known as mustard gas or simply as mustard. Other blister agents are nitrogen mustard; sulfur mustard; lewisite, a vesicant that contains arsenic; and phosgene oxime, a halogenated oxime that possesses dif...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2005.06.005

    authors: McManus J,Huebner K

    更新日期:2005-10-01 00:00:00

  • Is renal dose dopamine protective or therapeutic? No.

    abstract::This article argues that dopamine infused in low doses has not been shown to avert the onset of or ameliorate the course of acute renal failure in critically ill patients. The inotropic and diuretic effects of dopamine are discussed, and its adverse effects are described. An attempt is made to offer an evidence-based ...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0749-0704(05)70272-4

    authors: Cottee DB,Saul WP

    更新日期:1996-07-01 00:00:00

  • The use of erythropoiesis-stimulating agents in the intensive care unit.

    abstract::Anemia is common in critically ill patients, but treatment with red blood cell transfusions can have unwanted effects. Limiting the occurrence and severity of anemia by using erythropoietic agents (iron and/or recombinant erythropoietin), therefore, remains an attractive option during the intensive care unit stay but ...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2012.04.003

    authors: Piagnerelli M,Vincent JL

    更新日期:2012-07-01 00:00:00

  • An introduction to ultrasound equipment and knobology.

    abstract::The use of ultrasonography in medical practice has evolved dramatically over the last few decades and will continue to improve as technological advances are incorporated into daily medical practice. Although ultrasound machine size and equipment have evolved, the basic principles and fundamental functions have remaine...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2013.08.006

    authors: Enriquez JL,Wu TS

    更新日期:2014-01-01 00:00:00

  • Acute kidney injury in critically ill patients with cancer.

    abstract::Critically ill cancer patients have a higher incidence of acute kidney injury treated with renal replacement therapy than critically ill patients without cancer. Acute kidney injury may occur as a direct or indirect consequence of the cancer itself, its treatment, or associated complications. Several recent studies ha...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2009.09.002

    authors: Benoit DD,Hoste EA

    更新日期:2010-01-01 00:00:00

  • Critical care in India.

    abstract::India is a vast democracy of nearly one billion people. Before the British rule ended in 1947, the life span of an Indian was a mere 21 years. Within a short span of 50 years, it increased to an impressive 63 years, largely due to public health measures initiated by the government. This created a pool of more than 300...

    journal_title:Critical care clinics

    pub_type: 历史文章,杂志文章,评审

    doi:10.1016/s0749-0704(05)70312-2

    authors: Udwadia FE,Guntupalli KK,Vidyasagar D

    更新日期:1997-04-01 00:00:00