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Home  >  Medical Research Archives  >  Issue 149  > Critical Care Anywhere: Principles for High-Functioning Management in Low-Resource Environments
Published in the Medical Research Archives
Jan 2021 Issue

Critical Care Anywhere: Principles for High-Functioning Management in Low-Resource Environments

Published on Jan 28, 2021

DOI 

Abstract

 

Critically ill patients can present at any time and location, and they demand high quality care. Historical experiences from military, wilderness, and disaster medicine settings have helped shape the modern concept of caring for the most severely ill with limited available resources. We introduce a method to help design a successful critical care medical support endeavor, which includes properly defining components of Navigation, Environment, Resupply, Energy, Unconventional problems, and Support (NEREUS). Additionally, we provide recommendations for optimal team personnel composition, including utilization of paramedics, critical care providers, nurses, and respiratory therapists across the spectrum of care provided at point of injury, en route to definitive care, and definitive care. A review of critical care principles relevant to the austere setting proceeds with a systematic organization according to airway, breathing, circulation, and neurologic management. Lastly, we employ our proposed method of organizing a critical care medical support endeavor to a post-hurricane scenario. In summary, this review provides the historical background, modern definition, and practical framework for successfully administering critical care in scenarios with limited available resources. We emphasize the need to appropriately adapt critical care concepts to meet the unique demands of a specific scenario.

Author info

Jason Stankiewicz, Robert Ward, Michael Mccurdy

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