Ken Hillman – författare

Why Critical Care Evolved METs? In early 2004, when Dr. Michael DeVita informed me that he was cons- ering a textbook on the new concept of Medical Emergency Teams (METs), I was surprised. At Presbyterian-University Hospital in Pittsburgh we int- duced this idea some 15 years ago, but did not think it was revolutionary enough to publish. This, even though, our fellows in critical care medicine training were all involved and informed about the importance of “C- dition C (Crisis),” as it was called to distinguish it from “Condition A (Arrest). ”We thought it absurd to intervene only after cardiac arrest had occurred,because most cases showed prior deterioration and cardiac arrest could be prevented with rapid team work to correct precluding problems. The above thoughts were logical in Pittsburgh, where the legendary Dr. Peter Safar had been working since the late 1950s on improving current resuscitation techniques, ?rst ventilation victims of apneic from drowning, treatment of smoke inhalation, and so on. This was followed by external cardiac compression upon demonstration of its ef?ciency in cases of unexpected sudden cardiac arrest. Dr. Safar devoted his entire professional life to improvement of cardiopulmonary resuscitation. He and many others emphasized the importance of getting the CPR team to o- of-hospital victims of cardiac arrest as quickly as possible.

Why Critical Care Evolved METs? In early 2004, when Dr. Michael DeVita informed me that he was cons- ering a textbook on the new concept of Medical Emergency Teams (METs), I was surprised. At Presbyterian-University Hospital in Pittsburgh we int- duced this idea some 15 years ago, but did not think it was revolutionary enough to publish. This, even though, our fellows in critical care medicine training were all involved and informed about the importance of “C- dition C (Crisis),” as it was called to distinguish it from “Condition A (Arrest). ”We thought it absurd to intervene only after cardiac arrest had occurred,because most cases showed prior deterioration and cardiac arrest could be prevented with rapid team work to correct precluding problems. The above thoughts were logical in Pittsburgh, where the legendary Dr. Peter Safar had been working since the late 1950s on improving current resuscitation techniques, ?rst ventilation victims of apneic from drowning, treatment of smoke inhalation, and so on. This was followed by external cardiac compression upon demonstration of its ef?ciency in cases of unexpected sudden cardiac arrest. Dr. Safar devoted his entire professional life to improvement of cardiopulmonary resuscitation. He and many others emphasized the importance of getting the CPR team to o- of-hospital victims of cardiac arrest as quickly as possible.

This new edition provides an accessible account of the essentials of intensive care medicine. The core of the book focuses on areas common to all critically ill patients including fluid therapy, sedation, shock, infection and other central topics. This key understanding of basic pathophysiological principles provides an excellent launch pad for the section on individual disease entities encompassing haematology, gastroenterology, nephrology, endocrinology, the respiratory system, cardiovascular pathology, poisoning and neurology. Economic and ethical issues are also covered, and the text is supported by numerous problem-oriented guidelines to help the care provider tackle real-life practical problems as encountered in the ICU. In the same spirit, wherever possible, the authors provide precise and meaningful advice, rather than bland generalisations. This new edition reflects the excitement, challenges and uniqueness of intensive care medicine, for the benefit of all residents, trainees, nursing staff and paramedics attached to the ICU.

The majority of us now die in hospitals and many of us will end up in an Intensive Care Unit (ICU) for the last few days of our lives. Yet for most people, what happens in an ICU remains a mystery. This collection of stories about the experiences of intensive care patients, their families and carers, is about ordinary people facing terrible tragedies and the ways they cope with them. The author, a practicing intensive care clinician, takes the reader on a journey inside an ICU and reveals to the public, for the first time, what really happens inside ICU. The book traces the personal tragedies of ICU patients and their families and the struggles of staff providing care in this critical environment. The core function of the ICU has slowly changed from being life saving to becoming life sustaining - even when there is no hope of a meaningful recovery. Admission to the ICU is often sudden and unexpected and there are few guidelines for dealing with dying under these circumstances. ICU patients are often in a coma or sedated, which means decisions relating to their care must be made by their families. Many of the stories in this collection are about the dilemmas associated with withdrawing and withholding treatment that are faced by family and medical staff in ICU each day. They are about the ways we die and the ways we deal with death. They are about the people who care for us in our last moments: not only our friends and family, but the doctors and nurses who care for us and face these tragedies daily. The book carefully details the pressures on staff and the ways they cope with the intensity of providing this level of care. It is brimming with moments of humour and sadness that cut through the institutional reality of ICU, revealing the very human experience of this institution.