Saudi Critical Care Journal

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Patients with critical illness and high mortality risk are frequently admitted to intensive care units (ICUs). Therefore, improving the quality of healthcare for these patients is essential. Improving overall health and following best practices for patient safety are important goals in the health-care sector; especially in critically ill patients. To achieve these goals, many researches have been conducted to develop procedures, protocols and improve ICU structure and design. To discuss the effectiveness of multidisciplinary team (MDT) implementation in ICUs in the Saudi Arabian hospitals and how would this approach significantly reduce ICU mortality rates and improves the quality of healthcare. This review search of electronic search engines was conducted, including ProQuest, Medline, and Google Scholar. The search was narrowed to a total of 21 articles between 2010 and 2020 articles were included, which were found to match the inclusion criteria. Findings indicated a positive effect of the MDT care on decreasing the ICU's mortality rates. The studies reviewed have documented the necessity of successful MDT care implementation for improved survival rates. A collaborative approach by the various health-care providers-nurses, physicians, intensivists, respiratory therapists, and pharmacists–enhances patient care, improves clinical outcomes, and reduces the mortality rate.

Phenytoin is a widely prescribed anti-epileptic drug (AED), but overdoses are common given its narrow therapeutic index. A 24-year-old male, a previously diagnosed case of seizure disorder on multiple AEDs, including phenytoin presented with breakthrough seizures to the medical emergency. The subsequent medical management of this patient led to an inadvertent iatrogenic overdose of phenytoin resulting in encephalopathy in this patient. Given our experience in this patient, we suggest using a newer class of AED for seizure control in a patient already on phenytoin, particularly if immediate therapeutic plasma phenytoin level monitoring is not readily available.

Background: Despite the tremendous efforts regarding post hospital discharge services, the literature regarding health status, social and medical support of ICU survivors in Saudi Arabia is very limited. The main aim of our study is to conduct a general survey to describe health, medical and social status of ICU survivors. Methods: This was a cross- sectional study conducted at a tertiary academic center in Saudi Arabia. The phone survey has been conducted by the study investigators after getting a verbal consent for participation. A list of patients who were discharged from the hospital after an intensive care unit's admission from January 2018 to December 2018 was obtained. Results: Majority of our participants have no issues in concentration and only small percentage reported that they experience one or more of anxiety, depression, despair, and blue mood. A larger percentage of our subjects were satisfied by the support they received from their relatives, social support, and access to medical services. Conclusion: ICU survivors discharged from one center in Saudi Arabia reported great general health and satisfied by social and medical support but functional and mental status and multidisciplinary team approach worth further investigations.

Background: Respiratory therapists (RTs) are one of the frontline healthcare workers fighting the coronavirus disease 2019 (COVID-19) in the clinical areas, such as intensive care units, and emergency rooms. There are no data to measure the current practice of RTs in Saudi Arabia toward COVID-19 patient management. This study aimed to measure the current practice of RTs to manage COVID-19 patients. Materials and Methods: A cross-sectional, self-administered online survey comprising 29 questions. The survey comprised two sections: A demographic focusing on participants' data and a section to measure the knowledge of practitioners about the proper management of patients with COVID-19. None of the RTs who completed the survey were excluded. Results: A total of 247 RTs from different regions of Saudi Arabia were included. Men RTs were (65.6%), and the mean age was 30.52 ± 2.1 years. The majority of the RTs answered the questionnaire questions correctly. Answering the questions correctly was associated with more years of experience and working in the central and eastern regions. More than 50% of the RTs answered three questions inaccurately; those questions pertained to the suitable tidal volume, the acceptable SpO₂ for critically ill patients, and the recommended trial period for noninvasive ventilation. Conclusions: Our cross-sectional study showed that RTs working in Saudi Arabia conformed to the current guidelines and recommendations for dealing with patients with COVID-19. The accurate knowledge in dealing with these patients was increased with years of experience. Future studies are required that recruit additional RTs from different countries and educational backgrounds.

Online since 15^th Dec, 2016