© 2003 BMJ Publishing Group & British Thoracic Society
EDITORIAL
Critical care
Improving the care for patients with acute severe respiratory disease
St James’s University Hospital, Beckett Street, Leeds LS9 7TF, UK; mark.elliott@lineone.net
Services to improve the care of patients with acute severe medical conditions in general, and respiratory disease in particular, need to be improved. This includes access to a non-invasive ventilation service, available 24 hours per day, in all hospitals admitting patients with acute medical conditions.
Keywords: critical care; acute severe respiratory disease; non-invasive ventilation; clinical governance
| The first 150 words of the full text of this article appear below. |
In the early 1960s the first coronary care units (CCU) were established and are now a "given" in every hospital admitting patients with acute cardiac disease. For patients admitted to hospital with physiological disturbance due to non-acute cardiac medical conditions, the only options are usually either admission to an intensive care unit (ICU) or to a general medical ward. Inevitably, given the differences in staffing and facilities with one nurse looking after one patient with comprehensive physiological monitoring on the ICU compared with perhaps only two or three nurses looking after 30 patients at night with minimal continuous monitoring on a general medical ward, some patients will be admitted to the ICU who could be managed elsewhere. This is economically disadvantageous. Alternatively, patients may be looked after in an area in which proper care is not possible. This is an issue of standards of care and clinical governance.
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