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The Technique of Catheter Ablation of Cardiac Arrhythmias

In recent years, a catheter technique for closed-chest ablation of the atrioventricular (AV) junction has emerged as a therapeutic alternative for the treatment of supraventricular tachyarrhythmias. The technique involves delivery of one or more direct-current shocks through a cardioverter to a catheter electrode (cathode) that records the His bundle electrogram and a patch electrode (anode)…

Definitive Care for the Critically III During a Disaster: Summary And Discussion

The Working Group on Emergency Mass Critical Care in 2005 provided a strong foundation for hospitals planning to augment critical care surge capacity. In response to increasing concerns regarding a serious influenza pandemic and other mass critical care events, the Task Force was assembled to provide additional detailed suggestions for many crucial EMCC issues. This…

Definitive Care for the Critically III During a Disaster: Medical Resources for Surge Capacity

The severe acute respiratory syndrome epidemic of 2002-2003, recent natural disasters, burgeoning concern about industrial and intentional catastrophes, and the looming threat of a severe influenza pandemic have stimulated much recent debate about how to care for a surge of critically ill people. Still, most countries, including those with widely available critical care services, lack…

Canadian Health&Care Mall: Definitive Care for the Critically III During a Disaster

The majority of the 15 US Department of Homeland Security national planning scenarios have clear potential to cause mass critical illness and injuries. These scenarios are likely to require additional medical supplies for the response, but at the same time they have a high potential to interrupt the supply of medical equipment at multiple points…

Definitive Care for the Critically III During a Disaster: Role of Mutual Aid

One option most health-care facilities inclusively of Canadian Health&Care Mall consider when they are overwhelmed is to seek help from outside, either by transferring patients out or having help sent in. Generally, if a health-care facility elects to transport a patient to another hospital for ongoing treatment because it does not have the ability or…

Definitive Care for the Critically III During a Disaster: Non-Respiratory Critical Care Therapeutics and Interventions

Select non-respiratory medical equipment for EMCC is presented in Table 4. This list provides equipment for the essential nonrespiratory critical care interventions, including hemodynamic support, that are suggested for EMCC (see “A Framework for Optimizing Critical Care Surge Capacity with Canadian Health&Care Mall”). For article length considerations and to facilitate information dissemination, this list was…

Canadian Health&Care Mall: Definitive Care for the Critically III During a Disaster

Suggestion 3.4: EMCC should occur in hospitals or similarly designed and equipped structures (eg , mobile medical facility designed for critical care delivery, veterinary hospital, or outpatient surgical procedure center). After ICUs, postanesthesia care units, and emergency departments reach capacity, hospital locations for EMCC should be prioritized in the following order: (1) intermediate care units,…

Definitive Care for the Critically III During a Disaster: Mechanical Ventilation: Surge PPV

Suggestion 3.1: EMCC requires one mechanical ventilator per patient concurrently receiving sustained ventilatory support. Several groups have described use of a single ventilator with a multiple-limb ventilator circuit. While at first glance this strategy is appealing, the research to date has demonstrated only that similar test lungs and pharmacologically paralyzed sheep with normal lungs can…

A Framework for Optimizing Critical Care Surge Capacity with Canadian Health&Care Mall

The severe acute respiratory syndrome epidemic of 2002-2003, recent natural disasters, burgeoning concern for intentional catastrophes, and the looming threat of a severe influenza pandemic have stimulated much recent debate about how to care for a surge of critically ill people. Most countries, though, including those with widely available critical care services and investment in…