The Surgical Critical Care Handbook PDF – Guidelines for Care of the Surgical Patient in the ICU
21.11 MB PDF
As care givers we are frequently required to manage patients with life threatening disorders. This is more likely in the ICU environment where surgical patients are treated. These patients not only require management of their surgical disorders but also correction of abnormalities characteristic of the critically ill. The surgical intensivist must therefore be well informed in many disciplines other than the surgical disorders in order to care for these patients appropriately. This frequently requires a team approach which includes input from anesthesiologists, internists, respirologists, nurses, respiratory therapists, social workers, ethicists and frequently members of the clergy.
To address all these issues, this handbook has benefited from input from many sources. The authors and coauthors are experts in their disciplines or have had recent personal exposure to management of the critically ill surgical patient during extensive postgraduate training. The first section of the text discusses pathophysiologic processes common to the critically ill patient and sets the stage for applying these general principles in managing specific surgical disorders, dividing these into two subsections — trauma and no trauma.
The geriatric population continues to increase with our improvements in technology and medical/surgical care in general leading to larger numbers of these patients requiring intensive care. Our chapter on the geriatric critically ill patient focuses on problems unique to this population as well general ICU management issues. Likewise there is great emphasis on the care of the critically ill pediatric patient where special skills are required in dealing with the psychological component as well as unique pathophysiologic response to illness.
Family dynamics, life and death issues, futility of treatment, consent for treatment and cessation of treatment are all very important issues in the ICU requiring sensitivity, empathy and honest open discussion with not only the patient but also with their family members and stakeholders. The chapter on application of biomedical ethical principles is aimed at preparing the intensive care team to deal with these issues.
As physicians we are very privileged to be afforded the precious gift of knowledge and skills to make a difference in the lives of our patients and with this privilege comes a deep sense of responsibility and gratitude for having been the recipients of these special gifts. This gratitude is best expressed by applying our skills to the ultimate benefit of our patients and expressing thanks for these gifts to our teachers and the Giver of all knowledge. We are also very privileged not only as physicians but also as teachers giving to our students and patients the benefits of our knowledge in such a way that when our students touch their patients it should be as if our own hands are touching those patients. This brings a level of solemnity and spirituality to our day-to-day care of our patients and their families.
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