[HSF] ICU Management Systems

[Prasanna Simha M]

The Resident does it or the Nurse does it or you yourself do it !!
Prasanna

On Wed, Apr 9, 2008 at 8:53 PM, Michael Firstenberg <msfirst at gmail.com>
wrote:

> what happens when residents are not available (OR . home. busy. etc)
> or when things get really busy?  also - not just management and
> supervision but also doing the work.  we all take the calls and run in
> in the middle of the night with huge problems - but who deals with a
> lot of the low key stuff?
>
> On 4/9/08, alsadd <alsadd at ksu.edu.sa> wrote:
> > Even though I work at a University Hospital but we follow Ed's model.
> > Surgeons look after the patients. I believe this is the way to train
> future
> > surgeons which we do. I believe it is no good to operate and let some
> one
> > else manage especially when we have residents who have to learn. That of
> > course means calls in the middle of the night for us the staff but we
> got
> > used to it. I am against having an intensivist when there are residents.
> >
> > Ahmed
> >
> > -----Original Message-----
> > From: openheart-l-bounces at lists.hsforum.com
> > [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Edward
> Bender
> > Sent: Tuesday, April 08, 2008 5:57 PM
> > To: OpenHeart-L at lists.hsforum.com
> > Subject: Re: [HSF] ICU Management Systems
> >
> > At our small community hospital, the cardiac surgeons manage the
> patients
> > from admit to discharge.  Last year, with the addition of an intensivist
> > service, I tried using them, but there were problems with availability
> and
> > expertise, so that ended quickly.  I do liberally use other services
> when
> > indicated, such as ID for endocarditis or severe surgical site
> infections,
> > pulmonologist (not so much for ventilator management, but to aid in
> keeping
> > patients off the ventilator), endocrinologist for poorly controlled or
> > refractory hyperglycemia and/or DKA (which happens once or twice a
> year).
> >
> > I have found the best adjunct to care is a well trained, caring, and
> > available physician assistant or nurse practitioner.  Unfortunately, in
> our
> > area, these folks are less easy to find.  Most go into primary care,
> since
> > in the USA, this is probably going to be the health care model of the
> future
> > (economically doing away with primary care physicians).
> >
> > Ed Bender, MD
> >
> >
> > On 4/8/08 6:46 PM, "Michael Firstenberg" <msfirst at gmail.com> wrote:
> >
> > > We are in the process of exploring options to assist in the pre/post-
> > > operative care of our patients.  Our current system has us taking
> > > full care and responsibility for all aspects of this process (pre-op
> > > eval/tune-ups, post-op management, line changes, vent weaning, call/
> > > working with consults, etc).  There are obvious pluses and minuses to
> > > this process.  What are the other systems which people have to work
> > > with and what parts of them do they like and dislike.  My concern is
> > > that there are always plenty of people who want to be Chiefs, but few
> > > who want to be Indians (American expression for many who want to
> > > direct and run the show - esp between 9am and 5pm, but few to
> > > actually do they real work - i.e. bedside care, put in orders, call
> > > and discuss with consults, lines, tubes, weaning, even talking with
> > > families and helping admit patients- and do it 24 hr a day and with
> > > the same vigor which we - as cardiac surgeons do - particularly in a
> > > world were our every move and outcome gets examined under a
> microscope).
> > >
> > > In short, who does the "real" work in your ICU?
> > >
> > > Thoughts?
> > > Comments?
> > > Since we obviously have answer all of the other pressing surgical
> > > questions and no one has anything else to talk about.
> > >
> > >
> > > -michael
> > > _______________________________________________
> > > OpenHeart-L mailing list
> > >
> > > Send postings to:
> > >  OpenHeart-L at lists.hsforum.com
> > >
> > > To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> > > http://mmp.cjp.com/mailman/listinfo/openheart-l
> > >
> > > All messages transmitted by the OpenHeart-L are subject to the
> policies
> > and
> > > disclaimers posted at:
> > > http://www.hsforum.com/listdisclaim
> > > -----------------------------------------
> >
> >
> > _______________________________________________
> > OpenHeart-L mailing list
> >
> > Send postings to:
> >  OpenHeart-L at lists.hsforum.com
> >
> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> > http://mmp.cjp.com/mailman/listinfo/openheart-l
> >
> > All messages transmitted by the OpenHeart-L are subject to the policies
> and
> > disclaimers posted at:
> > http://www.hsforum.com/listdisclaim
> > -----------------------------------------
> >
> > _______________________________________________
> > OpenHeart-L mailing list
> >
> > Send postings to:
> >  OpenHeart-L at lists.hsforum.com
> >
> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> > http://mmp.cjp.com/mailman/listinfo/openheart-l
> >
> > All messages transmitted by the OpenHeart-L are subject to the policies
> and
> > disclaimers posted at:
> > http://www.hsforum.com/listdisclaim
> > -----------------------------------------
> >
> _______________________________________________
> OpenHeart-L mailing list
>
> Send postings to:
>  OpenHeart-L at lists.hsforum.com
>
> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> http://mmp.cjp.com/mailman/listinfo/openheart-l
>
> All messages transmitted by the OpenHeart-L are subject to the policies
> and
> disclaimers posted at:
> http://www.hsforum.com/listdisclaim
> -----------------------------------------
>



-- 
Prasanna Simha M