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1、CriticalCareMedicineDr.HuangPeizhiZhongshanHospitalofFudanUniversitWhatiscriticalcaremedicine？Multidisciplinaryhealthcarespecialtycaresforpatientswithacute,life-threateningillnessorinjurywhichincludingcontinuumoflifesupportfromthescenethroughdischargeCoordina
2、tedcaresystems,analysisoftreatmentoptions,protocols,guidelinesforthecareofindividualpatientsMonitoringandtherapyIntensivecaremedicineinEuropeWhatiscriticalillness?AconditionwherelifecannotbesustainedwithoutinvasivetherapeuticinterventionsCharacterizedbyacutel
3、ossofphysiologicreserveCardiacarrest,shock,sepsis,severetrauma,comaDysfunctionofoneormoreorgansystems:hemodynamicinsufficiency,respiratoryfailure,abnormalitiesoffluidandelectrolytesCharactersofCCM(1)lifesupportfromsiteofaccidenttoinjuryduringtransportationand
4、managementinemergencydepartment(ED)andtosurgicalintervationinoperatingroomorinintensivecareunit(ICU)RequireemergencymedicineandIntensivecaremedicineCharactersofCCM(2)TeamactionbyphysicianswithvariousspecialtybackgroundsAddedexpertiseinresuscitationNofocusofin
5、teresttoasinglebodysystem,butwidevarietyofillnessIntensivist-abilitytoprovideeffectivecriticalcareisinallcasesEmergencyandcriticalcaremedicine(ECCM)systemPre-hospitalcare(self-help,helpfrombystanders,ambulancepersonnelviatransport)lifesupportinEmergencydepart
6、ment,operationroomandICUEMphysicianisbasedintheED,intensivistremainedinICUHistoryofCCMIn1940’s:physiciansittingatthebedsidethroughthelongnight1stICUopenedinEuropein1950’sIn1970：setupsocietyofCCMinUSASince1991:teachingofCCMinChinaIn2001:setupcommitteeofCCMinSh
7、anghaiIntensiveCareUnit(ICU)WhatisICU?Multidisciplinarymulti-professionalmedical/nursingfieldAveryhighnursetopatientratio(3-4:1)TheavailabilityofinvasivemonitoringTheuseofmechanicalandpharmacologicallifesustainingtherapies(mechanicalventilation,vasopressors,c
8、ontinuousdialysis,defibrillation,pacemaker)ServiceinICUElementaryserviceBedsidemonitorsystemTreatmentequipmentExperimentinstrumentElementaryServicePatientarea(specialfunctionalbedandbedsi
