黄培志-危重医学.ppt

Critical Care Medicine
Dr. Huang Peizhi
Zhongshan Hospital
of Fudan Universit
What is critical care medicine?
Multidisciplinary healthcare specialty cares for patients with acute, life-threatening illness or injury which including continuum of life support from the scene through discharge
Coordinated care systems, analysis of treatment options, protocols, guidelines for the care of individual patients
Monitoring and therapy
Intensive care medicine in Europe
What is critical illness ?
A condition where life cannot be sustained without invasive therapeutic interventions
Characterized by acute loss of physiologic reserve
Cardiac arrest, shock, sepsis, severe trauma, coma
Dysfunction of one or an systems : hemodynamic insufficiency, respiratory failure , abnormalities of fluid and electrolytes
Characters M (1)
life support from site of accident
to injury during transportation and
management in emergency department (ED)
and to
surgical intervation in operating room or
in intensive care unit (ICU)
Require emergency medicine and Intensive care medicine
Characters M (2)
Team action by physicians with various specialty backgrounds
Added expertise in resuscitation
No focus of interest to a single body system, but wide variety of illness
Intensivist - ability to provide effective critical care is in all cases
Emergency and critical care medicine (ECCM) system
Pre-hospital care (self-help, help from bystanders, ambulance personnel via transport)
life support in Emergency department , operation room and ICU
EM physician is based in the ED,
intensivist remained in ICU
History M
In 1940’s: physician sitting at the bedside through the long night
1st ICU opened in Europe in 1950’s
In 1970: set up society M in USA
Since 1991: teaching M in China
In 2001: set mittee M in Shanghai
Intensive Care Unit (ICU)
What is ICU ?
Multidisciplinary multi-professional medical/nursing field
A very high nurse to patient ratio (3-4:1)
The availability of invasive monitor