Principles of Critical Care Medicine
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INITIAL EVALUATION OF THE CRITICALLY ILL PATIENT
Initial care of critically ill pts must often be performed rapidly and before a thorough medical history has been obtained. Physiologic stabilization begins with the principles of advanced cardiovascular life support and frequently involves invasive techniques such as mechanical ventilation and renal replacement therapy to support organ systems that are failing. A variety of severity-of-illness scoring systems, such as APACHE (acute physiology and chronic health evaluation), have been developed. Although these tools are useful for ensuring similarity among groups of pts involved in clinical trials, guiding resource allocation, or monitoring quality assurance, their relevance to individual pts is less clear. These scoring systems are not typically used to guide clinical management.