Following the publication of the department of health document - Comprehensive Critical Care (2000), the majority of hospitals in England have set up Critical Care Outreach Teams. The Government provided a significant sum of money for hospitals to set up outreach services. There are now calls for an evaluation of their impact. The book is set out in five key sections. Each section features chapters that address the conceptual and real life issues. In each section there is a chapter, set out as a case study example, demonstrating how innovative practices and service developments are going on around critical care outreach. The book will draw upon the knowledge, experience and clinical expertise of senior critical care nurses and doctors from a critical care network. The book will have a definite practical application and will provide tips to enhance practice. * Chapters contain useful 'how to' guides, prompts for critical thinking and case studies. * Very little has previously been published on this topic

The incidence of unplanned escalations during hospitalization is undocumented, but estimates may be as high as 1.2 million occurrences per year in the United States. Rapid Response Teams (RRT) were developed for the early recognition and treatment of deteriorating patients to deliver time-sensitive interventions, but evidence related to optimal activation criteria and structure is limited. The purpose of this study is to determine if an Early Warning Score-based Critical Care Outreach (CCO) model is related to the frequency of unplanned intra-hospital escalations in care compared to a RRT system based on staff nurse identification of vital sign derangements and physical assessments. The RRT model, in which staff nurses identified vital sign derangements to active the system, was compared with the addition of a CCO model, in which rapid response nurses activated the system based on Early Warning Score line graphs of patient condition over time. Logistic regressions were used to examine retrospective data from administrative datasets at a 237-bed community non-teaching hospital during two periods: 1) baseline period, RRT model (n=5,875) (Phase 1: October 1, 2010 - March 31, 2011), and; 2) intervention period, RRT/CCO model (n=6,273). (Phase 2: October 1, 2011 - March 31, 2012). The strongest predictor of unplanned escalations to the Intensive Care Unit was the type of rapid response system model. Unplanned ICU transfers were 1.4 times more likely to occur during the Phase 1 RRT period. In contrast, the type of rapid response model was not a significant predictor when all unplanned escalations (any type) were grouped together (medical-surgical-to-intermediate, medical-surgical-to-ICU and intermediate-to-ICU). This is the first study to report a relationship between unplanned escalations and different rapid response models. Based on the findings of fewer unplanned ICU transfers in the setting of a CCO model, health services researchers and clinicians should consider using automated Early Warning score graphs for hospital-wide surveillance of patient condition as a safety strategy.

Comprehensive Critical Care: Adult is the most complete critical care textbook for any learner in adult practice. Developed by leading experts in critical care, this comprehensive textbook covers 10 topic areas, including -Neurologic Critical Care - Cardiovascular Critical Care -Respiratory Critical Care -Critical Care Infectious Disease -Hepatic, Gastrointestinal, and Hematologic/Oncologic Disease in the ICU -Renal and Metabolic Disorders in the ICU -Environmental and Toxicologic Injury - Pharmacologic Issues in the ICU -Surgical and Obstetrical Critical Care -Administrative and Ethical Issues in the Critically Ill This new resource includes up-to-date information on the full gamut of critical care topics, with dozens of charts and tables to aid study and copious references to guide further reading.

This major reference work is the most comprehensive resource on oncologic critical care. The text reviews all significant aspects of oncologic ICU practices, with a particular focus on challenges encountered in the diagnosis and management of the critically ill cancer patient population. Comprised of over 140 chapters, the text explores such topics as the organization and management of an oncologic ICU, diseases and complications encountered in the oncologic ICU, multidisciplinary care, surgical care, transfusion medicine, special patient populations, critical care procedures, ethics, pain management, and palliative care. Written by worldwide experts in the field, Oncologic Critical Care is a valuable resource for intensivists, advance practice providers, nurses, and other healthcare providers, that will help close significant knowledge and educational gaps within the realm of medical care for critically ill cancer patients.

The critical care unit manages patients with a vast range of disease and injuries affecting every organ system. The unit can initially be a daunting environment, with complex monitoring equipment producing large volumes of clinical data. Core Topics in Critical Care Medicine is a practical, comprehensive, introductory-level text for any clinician in their first few months in the critical care unit. It guides clinicians in both the initial assessment and the clinical management of all CCU patients, demystifying the critical care unit and providing key knowledge in a concise and accessible manner. The full spectrum of disorders likely to be encountered in critical care are discussed, with additional chapters on transfer and admission, imaging in the CCU, structure and organisation of the unit, and ethical and legal issues. Written by Critical Care experts, Core Topics in Critical Care Medicine provides comprehensive, concise and easily accessible information for all trainees.