Title: High-Yield Pearls for the ICU Patient in the ED
题目：几个急诊ICU的病人处理要点
Author 作者: Haney Mallemat

There have been so many great talks at ACEP 2013, but Dr. Michael Winters' talk "The ICU is NOT Ready for Your Patient" was chock full of great critical care pearls. Here are just a few:
Increased mortality for ICU patients boarding in the Emergency Department; the increase is 1.5% per each hour of delayed transfer.
急诊科ICU患者每延迟1小时转ICU，其死亡率将增加1.5 ％。
Intubated patients should receive analgesia BEFORE sedation; fentanyl is recommended because hemodynamically stable, but you can use anything. Good analgesia will also reduce total sedative dosing
气管插管的患者应该在给镇静药前镇痛，芬太尼为首选，因为它对血流动力学影响小，当然你可以使用任何药物。良好的镇痛效果也将减少总的镇静药药量。
Use continuous capnography for the intubated patient; can detect equipment malfunction and allow titration of ventilation
对气管插管的病人使用连续二氧化碳监测，可以检测出设备故障，可调节呼吸机。
Keep an eye out for abdominal compartment syndrome. Physical exam is not always conclusive, should obtain bladder pressures
要警惕腹腔筋膜室综合征。体检并不总是确凿的，应该监测膀胱压力
Reduce the risk of ventilator-associated pneumonia by keeping endotracheal cuff pressures adequate and keeping the head of bed elevated 30-45 degrees
为减少呼吸机相关性肺炎的风险，要保持充足的气管导管囊压力和保持床头抬高30-45度