Download Intensive Care: A Doctor's Journal by John F., M.D. Murray PDF

By John F., M.D. Murray

Intensive Care is an affecting view from the trenches, a professional doctor's minute-by-minute and daily account of existence within the extensive Care Unit (ICU) of a huge inner-city health center, San Francisco common. John F. Murray, for a few years leader of the Pulmonary and important Care department of the clinic and a Professor on the college of California, San Francisco, takes readers on his day-by-day ward rounds, introducing them to the desperately sick sufferers he treats in addition to to the younger physicians and scientific scholars who accompany him. Writing with compassion and information gathered over a protracted occupation, Murray offers the genuine tales of sufferers who appear with myriad issues: bronchial asthma, cardiac failure, gastrointestinal ailments, problems because of AIDS, the results of drug and alcohol abuse, emphysema. Readers will come clear of this ebook with a accomplished knowing of what an ICU is, what it does, who will get admitted, and the way medical professionals and nurses make judgements touching on life-threatening clinical difficulties.

in depth take care of severely sick sufferers is a brand new yet well-established and becoming department of drugs. Estimates recommend that 15 to twenty percentage of all hospitalized sufferers within the usa are handled in a radical or coronary care unit in the course of every one health facility remain, so there's a actual probability that the reader will both be admitted to an ICU himself or herself or is aware an individual who may be. Murray not just bargains a real-time account of the prognosis, remedy, and development of his sufferers over the process one month but additionally conveys a wealth of data approximately numerous illnesses and scientific tactics in succinct and easy-to-understand phrases. additionally, he elaborates on moral dilemmas that he confronts on a virtually day-by-day foundation: the level of sufferer autonomy, the denial of ICU care, the withdrawal of lifestyles aid, and physician-assisted suicide.

Murray concludes that ICUs are doing their activity, yet they can be even higher, more affordable, and--most important--more humane. His chronicle brings substance to an international recognized to such a lot people basically in the course of the fiction of tv.

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Although the cause of her pneumonia was promptly identified and treated, she has done poorly. When she came to us for breathing support, her right lung had collapsed from an internal rupture of a small cyst that allowed air to escape from the lung and accumulate around it. To re-expand the lung, we had to insert a large-bore tube through her rib cage into the chest cavity and connect it to a suction machine and drainage apparatus that hangs at her bedside. I have no choice but to continue the treatment started by her other physicians.

Today should be a little more relaxed than yesterday because there has been only one new admission, and because two of yesterday’s patients are gone (Patrick Guzman died and Jisoo Hong was transferred). The new medical residents and students will have a chance to get acquainted with the nurses and respiratory therapists with whom they will work the rest of the month, and from whom they have much to learn. ■ Ella Andrews, bubbling despite an active night on call, herds us to Gyula Vysinsky’s room and introduces me to the first-year resident who admitted her.

We have a Regional Poison Control Center that provides information and advice each year to more than seventy thousand callers from ten coun- DAY 4 36 Sunday / 37 ties in Northern California; the head of the Poison Center and his staff are also immensely helpful to us when patients with drug toxicity or drug overdosage are in the ICU. When it was recognized that San Francisco was one of the epicenters of the emerging AIDS epidemic, the city and its hospital reacted quickly by opening in 1983 the first AIDS outpatient clinic and, six months later, the first AIDS ward in the country.

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