tailieunhanh - Báo cáo y học: "Pro/Con debate: Should 24/7 in-house intensivist coverage be implemente"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Pro/Con debate: Should 24/7 in-house intensivist coverage be implemented? | Available online http content 12 3 216 Review Pro Con debate Should 24 7 in-house intensivist coverage be implemented Yaseen Arabi Intensive Care Department King Saud Bin Abdulaziz University for Health Sciences King Abdulaziz Medical City ICU 1425 PO Box 22490 Riyadh 11426 . Corresponding author Yaseen Arabi arabi@ Published 5 June 2008 This article is online at http content 12 3 216 2008 BioMed Central Ltd Critical Care 2008 12 216 doi cc6905 Abstract You are appointed director of a new large multi-discipline intensive care unit in an academic center. The hospital is affiliated with a medical school and as such there will be an adequate number of medical students residents and fellows specializing in critical care rotating through the unit. The unit will be a closed intensivist-led model. In setting up the call schedule for the intensivists you need to decide whether the mandate will be for the intensivists to provide 24 7 in-house coverage as opposed to off-hour coverage from home. You wonder about the sustainability of each model. Pro 24 7 in-house intensivist coverage should be implemented Intensivist coverage traditionally has followed the business hours model used in other professions with reduced availability during weekends weeknights and holidays. This type of staffing would be appropriate if the need for the service were limited to business hours or if delaying the service for example from the night to the next morning did not have any negative consequences. Clearly this is not the case in critical care. First critical illness does not recognize the boundaries of business hours and therefore qualified intensivists need to be available around the clock. Studies have demonstrated that 66 to 69 of intensive care unit ICU admissions are admitted during off-hours 1 2 . Second in no area more than in the ICU is the outcome of patients affected by providing the right treatment at the right time delays in such .

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