The backbone of in-patient care is the hospital ward, and I believe that this will remain so in the future. Shortcomings in the staffing, organization and layout of the conventional ward have been recog nized for a long time, but there have been few changes and not all these have benefited the patient. The evolution of specialized treat ment centres for poliomyelitis, thoracic surgery, burns and so on, showed the need for a new staffing structure-a re-organization of patient care and of secondary importance, new forms of accom modation. These regional or referral centres serve large populations or areas and are collectively known as specialized intensive care (or therapy) units. The idea of using similar principles of staffing, organ ization and facilities to serve each large district hospital came much later (1959) and was first applied in the United States. Thus, the general intensive care unit was born, a unit which would treat critically ill patients irrespective of the nature of their disease, in sharp contrast to the specialized intensive care unit. The staffing structure and technologies of the two are however similar. Special ized intensive care consists of a single speciality or two specialities, for example thoracic surgery and thoracic anaesthesia. General intensive care cannot be a speciality because it embraces the whole of acute medicine, acute surgery, accident surgery, toxicology and many more individual specialities. This very diversity makes it difficult to organize, but interesting to perform. Front Matter....Pages i-viii Principles of Intensive Care....Pages 1-28 Respiratory Failure....Pages 29-70 Oxygen Therapy....Pages 71-85 Disturbances of Acid-Base Balance....Pages 86-107 Disturbances of Metabolic Balance....Pages 108-139 Fluid Therapy and Nutrition....Pages 140-162 Cardiac Arrest and Shock....Pages 163-196 Coronary Care....Pages 197-211 Microbial Infections....Pages 212-229 Ventilator Treatment....Pages 230-283 Tracheostomy....Pages 284-289 Tracheostomy Care....Pages 290-302 Asthma....Pages 303-315 Acute Respiratory Failure due to Chronic Lung Disease....Pages 316-332 Chest Injuries....Pages 333-363 Common Acute Poisonings....Pages 364-384 Acute Salicylate Poisoning....Pages 385-392 Diabetic Acidosis....Pages 393-401 Renal Failure....Pages 402-434 Haemodialysis....Pages 435-458 Peritoneal Dialysis....Pages 459-471 Measuring, Recording and Monitoring....Pages 472-491 Back Matter....Pages 492-504
