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Compelling Ethical Challenges in Critical Care and Emergency Medicine

https://libcat.nshealth.ca/en/permalink/provcat45529
Andrej Michalsen, Nicholas Sadovnikoff, editors. --Cham: Springer , c2020.
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This book addresses the ethical problems that physicians have to face every day while caring for critically ill patients. Advances in medical technology, ageing societies worldwide, and their increased demands on health care systems have, on the one hand, led to better care and remarkable longevity in many parts of the world. On the other hand, however, improved treatments in many medical fields, amongst others in emergency and critical care, have resulted in more patients surviving with reduce…
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Other Authors
Michalsen, Andrej
Sadovnikoff, Nicholas
Responsibility
Andrej Michalsen, Nicholas Sadovnikoff, editors
Place of Publication
Cham
Publisher
Springer
Date of Publication
c2020
Physical Description
1 online resource (xix, 170 p.) : 10 illus. in color
ISBN
9783030431273
9783030431266 (Print ed.)
9783030431280 (Print ed.)
9783030431297 (Print ed.)
Subjects (MeSH)
Clinical Decision-Making - ethics
Critical Care - ethics
Critical Illness
Emergency Medicine - ethics
Ethics, Clinical
Specialty
Critical Care
Emergency Medicine
Ethics
Abstract
This book addresses the ethical problems that physicians have to face every day while caring for critically ill patients. Advances in medical technology, ageing societies worldwide, and their increased demands on health care systems have, on the one hand, led to better care and remarkable longevity in many parts of the world. On the other hand, however, improved treatments in many medical fields, amongst others in emergency and critical care, have resulted in more patients surviving with reduced quality of life. This entails tradeoffs for many patients, their families, and the teams caring for them. At the same time, health care expenditures have risen dramatically and have to be balanced against costs for other public goods. Finally, the humane aspects of care have often failed to keep pace with the remarkable technological strides made in recent years. In this book, experts in their respective fields describe compelling ethical challenges resulting from these discrepancies and discuss potential solutions. The book is primarily intended for clinicians who care for two of the most vulnerable patient subpopulations – those being treated in ambulances or emergency rooms, and those being treated at intensive care units – due in part to the fact that they may be temporarily or permanently incapacitated. Core medical skills, such as diagnosis and predicting outcomes, as well as implementing treatment, remain challenging. However, without adequate communication and collaboration both within the inter-professional treatment teams and between the teams and the patients/their families, delivering excellent care is difficult at best. Therefore, the so-called “soft skills” are given the attention they deserve in order to overcome the gap between technological progress and interpersonal standstill.
Contents
Part I. Introduction -- 1. How Ethics Can Support Clinicians Caring for Critically Ill Patients -- 2. Patients and Teams Caring for Them: Parallels Between Critical Care and Emergency Medicine -- Part II. Goal of Therapy, Teams and Patients -- 3. Indication and Prognostication -- 4. Consent, Advance Directives, and Decision by Proxies -- 5. Cultural Diversity -- 6. Interprofessional Shared Decision-Making -- 7. Shared Decision-Making With Patients and Families -- Part III. Extent of Treatment -- 8. Emergency Medicine and Critical Care Triage -- 9. Usage of Cutting-Edge Technology: ECPR -- 10. Usage of Cutting-Edge Technology: ECMO -- 11. Limiting Life-Sustaining Therapies -- 12. Advancing Palliative Care in Intensive Care and Emergency Medicine -- 13. Organ Donation and Transplantation -- Part IV. Disproportionate Care -- 14. Disproportionate Care, Ethical Climate, and Moral Distress -- Part V. The Way Ahead -- 15. To Treat or Not to Treat: How to Arrive at an Appropriate Decision Under Critical Circumstances -- Part VI. Epilogue -- 16. Epilogue: Critical Care During a Pandemic – A Shift from Deontology to Utilitarianism?
Format
e-Book
Location
Online
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Hemocoagulative Problems in the Critically Ill Patient

https://libcat.nshealth.ca/en/permalink/provcat31242
Giorgio Berlot, editor. --Milan: Springer , c2012.
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Since the very beginning of critical care medicine, much attention has been paid to the risk of bleeding, but only recently the risk of thrombosis has been recognized in critical patients; in fact, current laboratory investigationsáaimed to monitor blood coagulation are more focused on the assessment of the hemorrhagic than of the thrombotic risk. Since mid-90s, many studies have detected powerful pro-thrombotic actions of endogenous mediators in sepsis and other inflammatory conditions, includ…
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Other Authors
Berlot, Giorgio
Responsibility
Giorgio Berlot, editor
Place of Publication
Milan
Publisher
Springer
Date of Publication
c2012
Physical Description
1 online resource (xiii, 238 p. : 13 ill., 7 ill. in color)
ISBN
9788847024489
Subjects (MeSH)
Blood Coagulation Disorders
Critical Illness
Subjects (LCSH)
Anesthesiology
Emergency medicine
Critical care medicine
Surgery
Abstract
Since the very beginning of critical care medicine, much attention has been paid to the risk of bleeding, but only recently the risk of thrombosis has been recognized in critical patients; in fact, current laboratory investigationsáaimed to monitor blood coagulation are more focused on the assessment of the hemorrhagic than of the thrombotic risk. Since mid-90s, many studies have detected powerful pro-thrombotic actions of endogenous mediators in sepsis and other inflammatory conditions, including trauma and postoperative status. Unfortunately, the related complication are both hard to detect and extremely harmful. The volume provides a full coverage of the hemocoagulative problems in anesthesia and intensive care, taking into consideration the physiology and monitoring of hemostasis, its relation with sepsis, and the specific aspects of the various critical conditions - from trauma to burns, to heart and transplant surgery or acute renal failure
Contents
Physiology of Hemostasis -- Monitoring of Hemostasis -- Anticoagulation therapy in ICU patients -- Inborn Prothrombotic States -- Inborn Defects of the Coagulative System -- Inflammation and Coagulation -- Disseminated Intravascular Coagulation -- Coagulative Disturbancies in Trauma -- Hypothermia and Coagulative Disorders -- Hemostasis in Pregnancy and in Obstetric Surgery -- Hemostasis During Heart Surgery -- Hemocoagulative Aspects of Solid Organ Transplantation -- Antiphospholipid Antibody Syndrome -- Pulmonary-Renal Syndrome -- Coagulative Disorders after Central Nervous System Injury.
Format
e-Book
Location
Online
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