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Unconsciousness or Coma
  1. What do lawmakers in the state, outside the state, and worldwide have to do relevant to these issues?
    Here are further guidelines.

  2. What HIPAA, patient privacy, or similar issues are not applicable?
    Here are further guidelines.

  3. Critical care issues: What is on the list?
    Here are further guidelines.

  4. What is a coma?
    Here are further guidelines.

  5. How many causes of a coma are there?
    Here are further guidelines.

  6. How many reversible causes of cardiopulmonary arrest are there?
    Here are further guidelines.

  7. How do you proceed if a person is in a coma?
    Here are further guidelines.

  8. What is the category of this coma?
    Here are further guidelines.

  9. What are the causes of a coma?
    Here are further guidelines.

  10. Are there any differences between cardiac arrest and a coma?
    Here are further guidelines.

  11. Cardiac arrest: What are the symptoms?
    Here are further guidelines.

  12. What are the reversible causes of cardiac arrest?
    Here are further guidelines.

  13. What rules should you follow in this situation?
    Here are further guidelines.

  14. What is the person’s medical history?
    Here are further guidelines.

  15. Office of the Director of Public Health Illinois: What is the requirement?
    Here are further guidelines.

  16. How do you manage a coma patient?
    Here are further guidelines.

What rules should you follow in this situation?
When a patient goes into a coma, the facts with answers to the mentioned questions from emergency medicine physicians, critical care physicians, and supervisors should be displayed through the Internet for further deliberations about the correct diagnosis and treatment.

The state police are required to assist in these public services. This is in addition to replacing the licensing resources for physicians in American states and worldwide.

They are engaging in medical negligence and then putting everything under some other heading, including coronavirus, that is not justified. The virus is an issue for the current situation of the public, but it is not necessarily the cause and circumstance of so many deaths according to Doctor Asif Qureshi.

Various treasuries should immediately forward large government grants and government checks so that Doctor Asif Qureshi can educate American lawmakers, including all governors and specific required physicians through the Internet.

At this point there is a need to teach Illinois emergency medicine physicians and critical care physicians the reversible causes of cardiac arrest, the reversible causes of coma, and treatment.

What is the person’s medical history?
When was the person normal?

When did person start to experience acute medical issues?

What were the significant findings?

When did the person go into coma?

What is the profile of the treating physicians? How did the treating physicians verify the reversible causes of coma before the _______ of the person?

What should be displayed on the Internet?

Questions you need to answer on the Internet.

What was the date and time circumstances when the patient went into a coma?

What is the name of the patient?

What is the date of birth of the patient?

What is the name of the treating doctor seeing the patient every day, face to face and in person?

What is the name(s) of the nurse(s) who see the patient every day?

At what location is this patient receiving treatment?

What is the patient’s medical history of the main medical problem, from first emergence until now?

What other medical issues does the patient have?

What are the patient’s vitals, including date, time, and location?

What are the last known and previous pulse oximetry blood oxygen saturation results?

What are the last known and previous blood biochemistry results of the patient?

What is the diagnosis?

What is the treatment?

What should be included in a review of the diagnosis?

What should be included in a review of the treatment?

Office of the Director of Public Health Illinois: What is the requirement?
Issues that need public debate
Responsibilities of medical college deans in this situation.
Office of the Director of Public Health Illinois: What is the requirement?
On or before April 22, 2020, deans of these medical colleges could not publicly elaborate on cardiac arrest and coma. On or after April 27, 2020, deans of these medical colleges should publicly elaborate on cardiac arrest and coma. These public deliberations are relevant to the existing situation.

What is on the list?
1. Northwestern University Feinberg School of Medicine, 420 E. Superior St., Chicago, IL 60611
2. University of Illinois College of Medicine at Chicago Dean's Office, 1853 W. Polk St. Room 131 (M/C 784), Chicago, IL 60612
3. Rush Medical College, 600 S. Paulina St. Suite 202, Chicago, IL 60612
4. Chicago Medical School of Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road North, Chicago, IL 60064
5. Southern Illinois University School of Medicine, 801 N. Rutledge St., Springfield, IL 62702
6. University of Chicago Pritzker School of Medicine, 924 E. 57th St. Suite 104, Chicago, IL 60637
7. Midwestern University Chicago College of Osteopathic Medicine, 555 31st St., Downers Grove, IL 60515
8. Carle Illinois College of Medicine, 807 S. Wright St. Suite 320, Champaign, IL 61821
9. Loyola University Chicago Stritch School of Medicine, 2160 S. 1st Ave., Maywood, IL 60153
10. NorthShore University, 2650 N. Ridge Ave., Evanston, IL 60201

All other similar entities have similar responsibilities.

Let the office of the Director of Public Health help them answer the mentioned questions relevant to the existing situation.

They seem to only be after grants, salaries, and resources. Public service is not their focus.

What is another word for a dean of a medical college?
Principal of a medical college.

Deans of these medical colleges who cannot elaborate on issues related to cardiac arrest and coma on or after April 27, 2020, must be replaced as soon as possible.

What are the topics?
Cardiac arrest
Coma

Cardiac Arrest

What do you know about cardiac arrest?
What should you know about cardiac arrest?

Coma

What do you know about coma?
What should you know about coma?
How can a coma be prevented?
Why are these questions relevant to existing situations?

Doctor Asif Qureshi has answers to these questions.
With a simple click, the answers to the identified questions can be displayed for the public as well as specific physicians and administrators. Display the answers to these questions on your website. Doctor Asif Qureshi's focus is on public well-being. If you need Doctor Asif Qureshi to teach physicians and administrators, he can teach about cardiac arrest, coma, and many more healthcare issues. He can also forward guidelines and materials relevant to these issues to the Director of the Illinois Department of Public Health for circulation to others.

Areas in various states do not have in-person face-to-face critical care facilities.

Which areas in various states do not have in-person face-to-face critical care facilities?
Www.qureshiuniversity.com/criticalcareworld.html
Also known as areas with zero ICU Beds.

Here are Doctor Asif Qureshi’s guidelines.
There are 47 causes of coma.
There are 46 reversible causes of coma.
The treatment is to fix the underlying cause.
If others mention or someone else has mentioned that this patient has coronavirus, then emergency medicine physicians and critical care physicians should also focus on the 46 reversible, treatable causes of coma in addition to coronavirus-related issues.
The director of the state’s public health entity can provide statistics.
The governor of the state can provide insights about the economy and resources required.
It is the duty and responsibility of emergency medicine physicians and critical care physicians to guide actions in this situation. As of 5 pm on April 17, 2020, not a single emergency medicine physician or critical care physician from any American state had come forward to provide guidelines for other emergency medicine physicians, critical care physicians, or similar health care professionals. You can imagine the situation in other parts of the world.

If you have any further questions, call 773-561-6102 in Chicago, Illinois, or email Doctor Asif Qureshi at admin@qureshiuniversity.com

What is a coma?
Coma scale: How do you know a person is not in coma?
How do you manage a coma patient?
How many coma cases are there?
What are the causes of comas?
How do you categorize critical versus non-critical patients?
How do you do cardio pulmonary resuscitation?
How do you ask patients about their medical history?
How do you elaborate on the diagnosis?
How could this be prevented?

Many more issues.

This is relevant to the existing situation.
Emergency hospitals are being set up at various locations in Illinois. People are going into a coma and dying. There are many causes of comas.
Treatment is to fix the underlying cause.

What is a coma?
Unable to hear, see, and talk.
Pulse and respiratory rate exist in a coma.
A loss of consciousness, whether suddenly or over time.
A loss of mobility. Unable to walk. Unable to move extremities.
Make sure you know the reversible causes of a coma.

Are there any differences between cardiac arrest and a coma?
Yes.

Cardiac arrest: What are the symptoms?
Sudden collapse
No pulse
No breathing
Loss of consciousness

Sometimes other signs and symptoms occur before sudden cardiac arrest.
These might include:
Chest discomfort
Shortness of breath
Weakness
Palpitations

In a coma, the individual has a pulse and is breathing.
In a coma, the individual cannot engage in spontaneous eye opening, talking, or walking.

What are the reversible causes of cardiac arrest?
Hypoxia
Hypovolemia
Hypoglycemia
Hypokalemia
Hypothermia
Hydrogen ion excess (acidosis)
Hyperkalemia
Tamponade—cardiac
Tension pneumothorax
Toxins
Thrombosis (pulmonary embolus)
Thrombosis (myocardial infarction)
Trauma
Tachycardia ventricular. Pulseless cardiac arrest, including PEA, asystole, ventricular fibrillation, and ventricular tachycardia. The treatment for pulseless ventricular fibrillation and ventricular tachycardia is defibrillation.

S prevention

What are the reversible causes of a coma?

What are the likely irreversible causes of a coma?

What is a vegetative coma situation?

What should happen on or after April 10, 2020, relevant to these issues?
I/we should not wait until a patient dies and then ask the medical examiners office to determine the causes/circumstances of death.

Intervention should happen before the death of the patient.

When should the intervention relevant to such a patient happen?
As soon as the patient goes into coma and before death.

All governors and state department of public health directors must alert all medical emergency and critical care units about these facts. As soon as a patient goes into a coma, the state should display the patient’s profile and facts on the Internet.
The state department of public health should display a list of coma patients.

On or after April 11, 2020, make this an emergency public health law. When a patient goes into a coma, his/her profile with answers to these questions must be displayed on the Internet.

For example:

Illinois coma patient list with date and time of circulation.
New York coma patient list with date and time of circulation.
California coma patient list with date and time of circulation.

Spain coma patient list.
Italy coma patient list.

Wuhan coma patient list
Kashmir coma patient list.
Similar entities.

Patients are dying from causes and circumstances other than the coronavirus.

Doctor Asif Qureshi will provide further emergency medicine doctor guidelines and critical care doctor guidelines on the Internet.

If video conferencing is possible, it should be displayed.

What can I teach emergency medicine physicians and similar entities?

How many causes of a coma are there?
At least 47.
You have to correlate the causes of a coma and the causes of reversible cardiopulmonary arrest.

How many reversible causes of cardiopulmonary arrest are there?
At least 14.

The treatment is to fix the underlying cause.

How do you proceed if a person is in a coma?
Find the cause of the coma.
Treat the underlying cause.
Identify the causes of the coma and fix the underlying causes.
Here are further guidelines.

What is the category of this coma?
1. Severe head injury. What is the cause of the head injury?
2. Primary brain disorder. What is the cause of this brain disorder?
3. A lack of oxygen to the brain. What is the cause of the lack of oxygen to the brain?
4. Severe general or metabolic illness. What is the specific cause of the severe general or metabolic illness?


1. Severe head injury, most commonly from:
Motor vehicle accidents
Violence
Falls
2. Primary brain disorder
Brain Tumor and
Brain hemorrhage or Stroke
Brain infection
3. Lack of oxygen to the brain due to:
High Blood Pressure
Very low blood pressure or Shock
Cardiac Arrest
Severe Seizure Disorder
4. Severe general or metabolic illness.
Severe bodily infections
Severe acute liver or Kidney Failure
High carbon dioxide levels
Carbon Monoxide Poisoning
Toxicity from poisons, medication, Alcohol Abuse and Alcoholism , or Drug Abuse and Drug Addiction
Abnormal hormone levels, such as from the thyroid or adrenal gland
Abnormal blood chemistries, such as sodium or calcium
Very low or very high levels of blood sugar
Very low or very high body temperatures
Severe nutrient deficiency
Liver failure
Kidney Failure
Inherited metabolic diseases

What are the causes of a coma?
  1. Alcohol intoxication

  2. Alcohol Poisoning

  3. Anesthesia Induces Coma

  4. Asphyxia (Oxygen deficiency)

  5. Abnormal blood chemistries, such as sodium or calcium

  6. Abnormal hormone levels, such as from the thyroid or adrenal gland

  7. Blood Loss

  8. Blunt Force Trauma

  9. Carbon Monoxide Poisoning

  10. Cardiac Arrest

  11. Cerebrovascular Accident

  12. Coma and Dehydration

  13. Coma in the Elderly: Evaluation and Treatment

  14. Compression

  15. Concussion

  16. Dehydration

  17. Drug Overdose

  18. Epileptic Fits

  19. Extremes of Body Temperature

  20. Fainting

  21. Head Injury

  22. Heart Rhythm Problems

  23. Heat Stroke

  24. High Blood Pressure

  25. High carbon dioxide levels

  26. Hyperglycaemia

  27. Hyperventilation

  28. Hypoglycaemia

  29. Hypothermia

  30. Hysteria

  31. Infantile Convulsions

  32. Inherited metabolic diseases

  33. Kidney Failure

  34. Liver failure

  35. Low Blood Pressure

  36. Low Blood Sugar (Hypoglycemia)

  37. Medically Induced Coma

  38. Poisonous Substances and Fumes

  39. Road traffic crash

  40. Severe Bleeding

  41. Severe nutrient deficiency

  42. Skull Fracture

  43. Straining

  44. Syncope (Fainting)

  45. Traumatic Brain Injury

  46. Very low blood pressure or Shock

  47. Coma and Persistent Vegetative State

Coma and Persistent Vegetative State
Is there any treatment?
Once an individual is out of immediate danger, the medical care team focuses on preventing infections and maintaining a healthy physical state. This will often include preventing pneumonia and bedsores and providing balanced nutrition. Physical therapy may also be used to prevent contractures (permanent muscular contractions) and deformities of the bones, joints, and muscles that would limit recovery for those who emerge from coma.

What research is being done?
Here are further guidelines.

Unconsciousness or Coma
Annotation or Definition
    Is there a difference between unconsciousness and sleep?
    What is the difference between unconsciousness and sleep?
    Is there a difference between unconsciousness and coma?
    Unconsciousness or coma: Is it a sign, finding, complaint, diagnosis, or all of them?
    What is the annotation or definition of this medical condition?
    What is a Coma?
    What happens during a coma?
    How do you differentiate between sleep and unconsciousness?
    Here are further guidelines.
Causes of Unconsciousness
    What are the causes of unconsciousness or coma?
    What Causes a Coma?
    What are the causes of a coma?
    1. Alcohol intoxication

    2. Alcohol Poisoning

    3. Anesthesia Induces Coma

    4. Asphyxia (Oxygen deficiency)

    5. Abnormal blood chemistries, such as sodium or calcium

    6. Abnormal hormone levels, such as from the thyroid or adrenal gland

    7. Blood Loss

    8. Blunt Force Trauma

    9. Carbon Monoxide Poisoning

    10. Cardiac Arrest

    11. Cerebrovascular Accident

    12. Coma and Dehydration

    13. Coma in the Elderly: Evaluation and Treatment

    14. Compression

    15. Concussion

    16. Dehydration

    17. Drug Overdose

    18. Epileptic Fits

    19. Extremes of Body Temperature

    20. Fainting

    21. Head Injury

    22. Heart Rhythm Problems

    23. Heat Stroke

    24. High Blood Pressure

    25. High carbon dioxide levels

    26. Hyperglycaemia

    27. Hyperventilation

    28. Hypoglycaemia

    29. Hypothermia

    30. Hysteria

    31. Infantile Convulsions

    32. Inherited metabolic diseases

    33. Kidney Failure

    34. Liver failure

    35. Low Blood Pressure

    36. Low Blood Sugar (Hypoglycemia)

    37. Medically Induced Coma

    38. Poisonous Substances and Fumes

    39. Road traffic crash

    40. Severe Bleeding

    41. Severe nutrient deficiency

    42. Skull Fracture

    43. Straining

    44. Syncope (Fainting)

    45. Traumatic Brain Injury

    46. Very low blood pressure or Shock
Complications
    What complications can occur?
    What is brain death?
    Here are further guidelines.
Diagnosis
    What is the Glasgow Coma Scale?
    Here are further guidelines.
Diagnostic tests
    How is coma assessed?
    What tests are there for coma?
    What is the outcome and prognosis for a patient in a coma?
    Induced Coma
    Here are further guidelines.
Disabilities associated with this medical condition
    Here are further guidelines.
Emergencies associated with this medical condition
    Is it a medical emergency?
    Yes.
Epidemiology
    How many such cases occur worldwide every year?
    Here are further guidelines.
History of this medical condition
    How has diagnosis and treatment of this medical condition evolved?
    Here are further guidelines.
Medical history relevant to this medical condition
    What medical history should you seek relevant to this issue?
    Here are further guidelines.
Mechanism or pathogenesis
    What happens in this medical condition?
    Here are further guidelines.
Normal values
    Here are further guidelines.
Prevention
    How can this medical condition be prevented?
    Can I do something to prevent Coma?
    Can coma be caused by anything other than Head injury?
    Here are further guidelines.
Relevant anatomy, physiology, or biochemistry
    Here are further guidelines.
Risk factors
    Here are further guidelines.
Research
    What research is being done on this issue?
    How can I help?
    How can you help?
    Here are further guidelines.
Symptoms and signs
    How is this medical condition reported?
    What should happen before reporting this medical condition?
    Victims usually do not report this medical condition.
    Others report this medical condition.
    Here are further guidelines.
Types
    What are the types of this medical condition?
    Here are further guidelines.
Treatment or management
    What are various treatment options?
    Treat the underlying cause.

    What is the best setting or location to treat this medical condition?
    Do on-the-spot treatment as described.
    Shift to ER or ICU after the on-the-spot treatment.
    Here are further guidelines.

Severe Bleeding

Put direct pressure on the wound with your fingers, using a sterile dressing if possible, to stop blood escaping.

Firmly wrap a bandage around the pad or dressing on top of the wound to control the bleeding. Make it firm enough to maintain pressure but not so tight that it restricts their circulation.

Treat them for shock: lay them down with their head low and thier legs raised and supported.

If blood shows through the pad or dressing, don’t remove it: apply a second dressing on top of the first one. If blood then seeps through both dressings, remove both of them and replace them with a fresh dressing. When changing dressings, make sure you keep pressure applied to where the bleeding is coming from.

If you can, support the injured area. For example, you can rest a leg on some cushions, or for an arm you can make a sling.

Keep checking the casualty's breathing, pulse and level of response.

If they become unresponsive at any point, open their airway, check their breathing, and prepare to treat someone who has become unresponsive.

Syncope (Fainting)

What is syncope?
Syncope is temporary loss of consciousness and posture, described as "fainting" or "passing out." It's usually related to temporary insufficient blood flow to the brain. It most often occurs when the blood pressure is too low (hypotension) and the heart doesn't pump a normal supply of oxygen to the brain.

What causes syncope?
It may be caused by emotional stress, pain, pooling of blood in the legs due to sudden changes in body position, overheating, dehydration, heavy sweating or exhaustion. Syncope may occur during violent coughing spells (especially in men) because of rapid changes in blood pressure. It also may result from several heart, neurologic, psychiatric, metabolic and lung disorders. And it may be a side effect of some medicines.
Some forms of syncope suggest a serious disorder:

•those occurring with exercise
•those associated with palpitations or irregularities of the heart
•those associated with family history of recurrent syncope or sudden death

What is neurally mediated syncope?
Neurally mediated syncope (NMS) is called also neurocardiogenic, vasovagal, vasodepressor or reflex mediated syncope. It's a benign (and the most frequent) cause of fainting. However, life-threatening conditions may also manifest as syncope. NMS is more common in children and young adults, although it can occur at any age. NMS happens because blood pressure drops, reducing circulation to the brain and causing loss of consciousness. Typical NMS occurs while standing and is often preceded by a sensation of warmth, nausea, lightheadedness and visual "grayout." If the syncope is prolonged, it can trigger a seizure. Placing the person in a reclining position will restore blood flow and consciousness and end the seizure.

Medically Induced Coma
What Is a Medically Induced Coma and Why Is It Used?
In the case of traumatic brain injury—such as the bullet wound sustained by U.S. Rep. Gabrielle Giffords in Saturday's assault outside a Tucson supermarket that killed six people and wounded 13 others—doctors sometimes induce a coma. This effective shutdown of brain function naturally occurs only in cases of extreme trauma, so why would doctors seek to mimic it in patients, as they have with the congresswoman, already suffering from head wounds and other issues?

The answer lies in the science behind general anesthesia, which some 60,000 patients undergo every day. A review paper in the December 30, 2010, issue of The New England Journal of Medicine reveals that such anesthesia is, essentially, a reversible coma.

That is exactly what doctors are aiming for in the case of a true medically induced coma, often using the same drugs or extreme hypothermia induced by exposure to a cold environment to halt blood flow entirely and permit surgery on the aorta. Shutting down function can give the brain time to heal without the body performing radical triage by shutting off blood flow to damaged sections. To find out more about such medically induced comas and the reasons why doctors employ them, Scientific American spoke with anesthesiologist Emery Brown of Harvard Medical School, co-author of the NEJM review.

What is a medically induced coma?
So basically what happens with a medically induced coma is that you take a drug and administer it until you see a certain pattern in the monitor that follows the patient's brain waves, the EEG [electroencephalogram]. Patients with brain injuries who are in a coma have a similar pattern. If that pattern is there, then you feel comfortable that the patient is in a drug-induced coma. You are doing it so that you can hopefully protect the brain.

What are you protecting the brain from?
If you've had a brain injury, what happens is the metabolism of the brain has been significantly altered. You may have areas without adequate blood flow. The idea is: "Let me reduce the amount of energy those different brain areas need." If I can do that then, as the brain heals and the swelling goes down, maybe those areas that were at risk can be protected.

But the main thing about a drug-induced coma, as opposed to a coma, is that it's reversible. If you do this to someone with a normal brain, they would come right out of it once you removed the drugs.

But it's used in the case of people with brain injuries. So what are the risks? Speaking generally, the main effects that these drugs have outside the brain is they reduce blood pressure. So people trying to do this are giving a lot of other medicines to keep blood pressure up and keep the heart pumping in a nice way. You're protecting the brain on one hand and, on the other hand, all areas of the brain are not getting the blood they need necessarily.

If you do this for an extended period of time, the drugs can accumulate and it may take them a while to wash out of the system as well. As long as you're mindful of these things you can see someone through a period like this.

How long is that period?
It really depends on the injury, whether it's a brain injury or seizing. One patient was kept in [a drug-induced coma] for six months. Obviously, that's the tail end of the distribution.

It depends on how the person is progressing and the nature of the injury. What the neurologists or [intensive care unit] doctors do is try to have them come out as soon as possible. In a case like Gifford's they have swelling. If they see the swelling recede, then they may try to lighten up the coma to see if she can come back and see what her level of function is.

How safe are drug-induced comas?
A drug like propofol, we use this every day in the operating room. It is probably the most used drug in all of anesthesia. Every day essentially, when patients go under general anesthesia that whole state is a reversible coma. It's a difference in dosage.

How does a medically-induced coma differ from a natural coma?
The body doesn't usually decide to enter a coma. A coma is a profound shutdown of brain function. It typically results from profound trauma, brain injury, a drug overdose, stroke—some very gross insult. There isn't a natural analogue for [a medically induced coma].

Are there after effects?
It's hard to sort out, because if you're going to these extremes you're already dealing with a very dire situation. If there are effects later on, it's an extremely difficult distinction to make whether it is an effect of the drug-induced coma. People who do this are very mindful of watching and monitoring. They make every effort to only use this option for as long as they need to.

Physician intensive care unit
Critical Care Services
Critical Care
Here are further guidelines.


Assessment of a patient by a physician.
  1. Glasgow Coma Scale

  2. Level of consciousness

  3. Pulse rate:

  4. Respiratory rate:

  5. Blood pressure:

  6. Temperature:

  7. Oxygen saturation by pulse oximetry

  8. Arterial blood gas

  9. Chemistry Panels

  10. Monitoring the critically ill patient

  11. What is the treatment plan?

  12. Discharging a Person from Intensive Care
  1. First time assessment of a patient in a critical situation by an intensive care physician.

  2. Follow-up of a patient in a critical care unit by a specific physician.

  3. Follow-up of a patient by a specific physician or team of physicians at home.

  4. Home care of a patient after a diagnosis and treatment at a critical care unit.

  5. Critical care unit record

New Critical Care Patient

First time assessment of a patient in a critical situation by an intensive care physician.

Assessment
Here are further guidelines.

Where is the patient now?

____________________________________

What seems to be the issue or issues?

____________________________________

What assessment type does the patient need at this point?

____________________________________

Emergency health assessment on the spot.
Emergency health assessment in a medical emergency room.
Emergency health assessment in an intensive care unit.
Emergency health assessment for pregnancy, childbirth, and puerperium for women of childbearing age.
Emergency medicolegal case of human.
Non-emergency medicolegal case of human.
Detailed health assessment for patient.
Follow-up health assessment.
New issue that does not need an emergency assessment.
Personality disorders screening

Emergency health assessment in an intensive care unit.

First, analyze Glasgow Coma scale, then analyze vital signs including consciousness.

When was the patient normal?

____________________________________

Can the patient open both eyes spontaneously?

____________________________________

Can the patient talk or make noise relevant to age?

____________________________________

Can the patient walk or move extremities relevant to age?


____________________________________
If yes, Glasgow Coma scale is 15.
Glasgow Coma scale of 15 means the patient is not in a coma.
The patient can have less serious medical issues.
Go ahead with vital signs, including consciousness.

Level of consciousness
Pulse rate:
Respiratory rate:
Blood pressure:
Temperature:

What is the oxygen saturation by pulse oximetry?

Arterial blood gas

1. Is the pH normal?
2. Is the CO2 normal?
3. Is the HCO3 normal?
4. Match the CO2 or the HCO3 with the pH
5. Does the CO2 or the HCO3 go the opposite direction of the pH?
6. Are the pO2 and the O2 saturation normal?

1. Metabolic Acidosis
2. Metabolic Acidosis, Fully Compensated
3. Metabolic Acidosis, Partially Compensated
4. Metabolic Acidosis, Uncompensated
5. Metabolic Alkalosis
6. Metabolic Alkalosis, Partially Compensated
7. Metabolic Alkalosis, Uncompensated
8. Respiratory Acidosis
9. Respiratory Acidosis, Fully Compensated
10. Respiratory Acidosis, Partially Compensated
11. Respiratory Acidosis, Uncompensated
12. Respiratory Alkalosis
13. Respiratory Alkalosis, Fully Compensated
14. Respiratory Alkalosis, Partially Compensated
15. Respiratory Alkalosis, Uncompensated

What best describes the diagnosis among the listed critical care diagnoses?
1. Acute respiratory failure type 1 (hypoxemic), type 2 (hypercapnic/ventilatory), type 3 (peri-operative), type 4 (shock)
2. Acute renal failure
3. Acute vision loss
4. Cardiac dysrhythmia
5. Coma
6. Chronic respiratory (lung) failure with or without acute sequelae.
7. Chronic renal failure with or without acute onset
8. Dementia and Alzheimer’s: What are the differences?
9. Diabetic coma in type 2 diabetes
10. Diabetic ketoacidosis (DKA)
11. Heart failure
12. Medical conditions that need further evaluation and treatment in a critical care unit
13. Multiple organ failure
14. Not taking care of oneself
15. Polytrauma
16. Poisoning and drug overdose
17. Post-operative intensive care
18. Renal conditions that need critical care services or dialysis
19. Septicemia
20. Shock
21. Stroke
22. Trauma
23. Traumatic brain injury
24. Unconsciousness or coma
25. Starvation; survival needs from state.
26. Critical Care of the Burn Patient: The First 48 Hours.
27. Other issues that need critical care.

If a person does not have a critical care diagnosis, that person can still have a medical emergency diagnosis.

Who is the treating doctor?

__________________________________________

What's your answer?


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Diagnosis

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Discharging a Person from Intensive Care
Who makes the decision to discharge a person from ICU?
The ICU team makes the decision about when a person is ready for discharge to a ward. Terms such as ‘cleared for the ward’ or ‘booked out’ might be used.

The decision to discharge is usually made together with the person’s primary care team or doctor who the person was admitted under when they first came to the hospital. Generally, this decision is made on the morning ICU ward round, although some ICUs have rounds twice a day.

To which ward does the person go?
This will depend on:
?the particular hospital
?what condition the person has
?the person’s ongoing treatment and care needs.

In larger hospitals, the person will generally be moved to a speciality ward, whereas in smaller hospitals, it may be to the general wards.

If somebody came to ICU after being transferred from a smaller hospital, then they might be transferred back to that smaller hospital. This will usually only happen if the smaller hospital can provide the ongoing care that’s needed, and that there is a doctor able to look after the person’s medical needs.

Who is responsible for the ongoing treatment of the person discharged from ICU?
When someone is admitted to hospital, they are admitted under a physician who is given ongoing responsibility for the person’s medical care. But when a person is admitted to ICU, this responsibility is negotiated between the ICU staff and the physician.

When the ICU team is ready to discharge the person to a ward, they contact the physician the person was admitted under, and discuss the person’s present condition and future treatment plans.

Once the person is discharged to the ward or another hospital, it’s the admitting physician who resumes the full responsibility.

Preparing to leave ICU

Patients and relatives may notice a change in care as their loved one’s condition improves.

These changes usually involve:
?less monitoring and fewer interventions and treatments

?less nursing attention, as their nurse may have more than one person to look after

?removal of medical devices, such as the arterial line and urinary catheter

?increased rehabilitation activities, such as walking, to improve movement.

When do people leave ICU?
Once the person is cleared to discharge ICU, the ward manager is asked for a ward bed. The person will then be discharged once a ward bed becomes available. This usually happens on the same day, although it can take longer when the hospital is busy. Very occasionally, people are cleared for discharge and are moved to the ward during the evening or at night.

These decisions are sometimes made because there are other critically ill people who need an ICU bed. However, a person will only be discharged from ICU if their condition has improved and the ward is able to provide the right care.

What happens when a person leaves ICU?
The medical and nursing staff complete paperwork to ensure a smooth move to the ward. Then the person can be taken to the ward, where a handover is given to the ward’s nursing team. Also, the medical team who will be caring for the person is contacted and provided with all the information they need.

What is an ICU liaison nurse?
Some hospitals have an ICU follow-up service, usually called ‘ICU Nurse Liaison’. This service was created to give continuous care during the changeover period. These nurses follow up the person for several days.

If you have any concerns about a person being discharged from ICU to a ward or another hospital, please speak to the ICU team.

Survival needs monitoring

Document for discharge from hospital emergency room.

Document for discharge from hospital other than emergency room.

Physician intensive care unit
Critical Care Services
Critical Care
Here are further guidelines.

Last Updated: November 15, 2020