Related Experiment Video
Updated: May 31, 2026
07:16
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Unsuitable for the intensive care unit: what happens next?
Alistair McKeown1, Malcolm G Booth, Laura Strachan
1Department of Palliative Medicine, Glasgow Royal Infirmary, Glasgow, United Kingdom. medichi@doctors.org.uk
Journal of Palliative Medicine
|June 30, 2011
Summary
Patients referred to intensive care units (ICU) but deemed unsuitable often experience severe breathlessness and may benefit from palliative care. Early identification aids end-of-life care planning.
Area of Science:
- Critical Care Medicine
- Palliative Care
- Health Services Research
Background:
- Increasing referrals to UK intensive care units (ICUs) include patients unsuitable for admission due to comorbidities or low survival likelihood.
- Inappropriate ICU admissions strain resources and may not align with patient prognosis or best interests.
Purpose of the Study:
- To investigate outcomes and symptom burden in patients unsuitable for ICU admission.
- To determine if this patient group has specific end-of-life care needs.
Main Methods:
- Observational prospective study design.
- Patients referred to ICU but deemed unsuitable were identified and followed on wards.
- Data collection focused on outcomes and symptoms.
Main Results:
- Fifty unsuitable patients identified (Jan-Apr 2009).
- One-week outcomes: 34% death, 24% discharge, 40% ongoing illness/rehabilitation.
- High comorbidity prevalence and severe breathlessness observed across all outcome groups.
Conclusions:
- A subset of patients with uncontrolled symptoms could benefit from palliative care specialist input.
- Identifying imminently dying patients facilitates communication and end-of-life care preparations.
- Improved identification supports social, psychological, and spiritual needs for dying patients.
Related Concept Videos
01:29Acute Respiratory Failure-V
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:24Endotracheal Tube Extubation
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals.
01:30Acute Respiratory Failure-III
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
01:28Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
01:17Endotracheal Intubation II: Nursing Management
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
01:26Acute Coronary Syndrome V: Nursing Management
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...