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The evaluation of severity of illness in the critically ill patient is made through the use of severity scores and prognostic models. Severity scores are instruments that aim at stratifying patients based on the severity of illness, assigning to each patient an increasing score as their severity of illness increases. Prognostic models, apart from their ability to stratify patients according to their severity, predict a certain outcome (usually the vital status at hospital discharge) based on a given set of prognostic variables and a certain modeling equation.

Ventilatory support which is delivered without establishing an endotracheal airway is called non-invasive ventilation (NIV).

Nosocomial infections are believed to occur most frequently in intensive care units (ICUs), and they affect the outcome of the patients admitted to the ICU. However, this notion was based on CDC/NNIS findings on their overall hospital surveillance of US hospitals in 1970–1990. This notion is, however, still true as far as the use of medical equipments concerned as an external risk factor for developing nosocomial infections. Because ICU is the place where medical equipment is most frequently used in the hospital, the number of the patients who acquire nosocomial infections becomes largest. This is the reason why ICUs became the target of nosocomial infection surveillance in the NNIS system. However, it does not mean that the strength of prevention of nosocomial infections in ICUs is inferior to that of other wards (in order to measure the performance of nosocomial infections preventing capability, infection rates should be calculated while risk adjustment is made). Nevertheless, the incidence of nosocomial infections is highest in ICUs. Therefore, strict preventive measures should be provided to improve the prognosis of the patients.

Pulmonary embolism (PE)is a relevant clinical occurrence. Despite advances in diagnostic modalities,PE remains a commonly under diagnosed and lethal disease. In North America it has been reported that the occurrence of 600 000 PE cases are accountable for 50 000 to 200 000 deaths annually [– ]. Unexpected deaths due to pulmonary embolism are frequently diagnosed post mortem. When diagnosis is established in the emergency department, appropriate anticoagulation is usually effective in reducing the possibility of recurrence and death. Undiagnosed PE has a hospital mortality rate as high as 30% that falls to near 8% if diagnosed and treated properly [– ]. The mortality rate in ambulatory patients is less than 2%[]. Clinicians are aware of unexpected deaths due to pulmonary embolism and that appropriate anticoagulation is usually effective in reducing the possibility of recurrence and death. For this reason,image methods are requested whenever there is clinical suspicion of PE. The diagnostic ‘gold standard’ is pulmonary angiography, against which other imaging modalities have been historically evaluated. Pulmonary angiography is an invasive and expensive procedure,with limited availability and potentially serious complications. There is limited radiological experience with this method as it is not always recognised that,with sub-segmental clot,interobserver disagreement occurs in up to one third of cases []. Despite being the ‘gold standard’ ,pulmonary angiograms are not infallible. A patient with a normal pulmonary angiogram can still expect a 2.2% (95%CI, 0.3 to 8.0%) venous thromboembolic event rate at the one-year follow-up [].

In October 2001, at the 8th World Congress of Intensive Care and Critical Care Medicine in Sydney, Australia, a meeting was held in one of the conference halls. Present were about 70 critical care nurses from 15 countries who had gathered to discuss the benefits of an international network of critical care nurses either through their representative national associations or as individuals.

Intensive care units (ICUs) are an expensive [–] and growing [,] part of health care in developed nations. Greater consumer expectations, ageing populations [, ], demand for sophisticated technologies [], and, in the United States (US), defensive medicine [] are increasing demand for intensive care. Intensive care is increasingly being provided to older and sicker patients, many of whom would not have been referred for intensive care in the past []. The proportion of health care resources needed may be seen as disproportionate [, –] but intensive care requires many highly skilled staff in a complex, expensive, technology-driven environment [].