Who benefits from Intensive Care in the field?
The limited capacity and resources of a Field Hospital Intensive Care Unit may necessitate the triage or prioritisation of critically ill patients requiring admission. The use of critical care resources by members of the local population in certain Areas of Operation, who can not be discharged or transferred to equivalent care in their local health service, impacts significantly on bed occupancy. Therefore available resources must be distributed efficiently and equitably with decisions guided by the principles of advocacy for the patient. Patients must be admitted only on the concept of potential benefit and reasonable chance of recovery, which would not be available elsewhere. Discriminating between seriously ill patients before admission and decision making regarding withdrawal of care is very difficult. Senior clinicians working regularly in a critical care setting demonstrate a better level of discrimination in assessing outcome of seriously ill patients and are best placed to make decisions regarding admission, continuation and withdrawal of treatment.
Birch
K
K
Department of Anaesthetics, North Bristol NHS Trust, Southmead Hospital, Bristol. tinabirch@doctors.org.uk
D003422:Critical Care; D003657:Decision Making; D003695:Delivery of Health Care / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D008887:Military Medicine / Q000458:organization & administration*; D008889:Military Personnel; D008952:Mobile Health Units / Q000458:organization & administration*; D014218:Triage; D006113:United Kingdom