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69-932: An ICU was defined by the task force of the World Federation of Societies of Intensive and Critical Care Medicine as “an organized system for the provision of care to critically ill patients that provides intensive and specialized medical and nursing care, an enhanced capacity for monitoring, and multiple modalities of physiologic organ support to sustain life during a period of life-threatening organ system insufficiency.” Intensive care units cater to patients with severe or life-threatening illnesses and injuries, which require constant care and close supervision from life-support equipment and medication in order to ensure normal bodily functions . They are staffed by highly trained physicians , nurses and respiratory therapists who specialize in caring for critically ill patients. ICUs are also distinguished from general hospital wards by

138-468: A significant comparison, numbers must be altered for the size of the population that is under study. For example, the fertility rate is calculated as the ratio of the number of births to women of childbearing age to the total number of women in this age range. If these adjustments were not made, we would not know if a nation with a higher rate of births or deaths has a population with more women of childbearing age or more births per eligible woman. Within

207-401: A country (or other entity) contains Population t persons at time t . What is the size of the population at time t + 1 ? Natural increase from time t to t + 1: Net migration from time t to t + 1: These basic equations can also be applied to subpopulations. For example, the population size of ethnic groups or nationalities within a given society or country is subject to

276-472: A higher staff-to-patient ratio and access to advanced medical resources and equipment that is not routinely available elsewhere. Common conditions that are treated within ICUs include acute respiratory distress syndrome , septic shock , and other life-threatening conditions. Patients may be referred directly from an emergency department or from a ward if they rapidly deteriorate, or immediately after surgery if

345-483: A hospital ward can offer) or on a 1:1 basis for patients requiring extreme intensive support and monitoring; for example, a patient on multiple vasoactive medications to keep their blood pressure high enough to perfuse tissue. The patient may require multiple machines; Examples: continuous dialysis CRRT , a intra-aortic balloon pump , ECMO . International guidelines recommend that every patient gets checked for delirium every day (usually twice or as much required) using

414-505: A larger facility if need be he/she may have demonstrated a significant decrease in stability. Medical emergency A medical emergency is an acute injury or illness that poses an immediate risk to a person's life or long-term health, sometimes referred to as a situation risking "life or limb". These emergencies may require assistance from another, qualified person, as some of these emergencies, such as cardiovascular (heart), respiratory, and gastrointestinal cannot be dealt with by

483-460: A new product, and to analyze certain dynamics of a company's workforce. Choosing a new location for a branch of a bank, choosing the area in which to start a new supermarket, consulting a bank loan officer that a particular location would be a beneficial site to start a car wash, and determining what shopping area would be best to buy and be redeveloped in metropolis area are types of problems in which demographers can be called upon. Standardization

552-498: A period of transition where in demography emerged from statistics as a separate field of interest. This period included a panoply of international 'great demographers' like Adolphe Quetelet (1796–1874), William Farr (1807–1883), Louis-Adolphe Bertillon (1821–1883) and his son Jacques (1851–1922), Joseph Körösi (1844–1906), Anders Nicolas Kaier (1838–1919), Richard Böckh (1824–1907), Émile Durkheim (1858–1917), Wilhelm Lexis (1837–1914), and Luigi Bodio (1840–1920) contributed to

621-419: A specific medical requirement or patient: Common equipment in an ICU includes mechanical ventilators to assist breathing through an endotracheal tube or a tracheostomy tube ; cardiac monitors for monitoring Cardiac condition; equipment for the constant monitoring of bodily functions; a web of intravenous lines , feeding tubes, nasogastric tubes , suction pumps, drains, and catheters , syringe pumps; and

690-426: A standardized mortality rate (SMR) or standardized incidence rate (SIR). Population change is analyzed by measuring the change between one population size to another. Global population continues to rise, which makes population change an essential component to demographics. This is calculated by taking one population size minus the population size in an earlier census . The best way of measuring population change

759-514: A time-dependent reduction in the mortality and morbidity . Demography Demography (from Ancient Greek δῆμος ( dêmos )  'people, society' and -γραφία ( -graphía )  'writing, drawing, description') is the statistical study of human populations : their size, composition (e.g., ethnic group, age), and how they change through the interplay of fertility (births), mortality (deaths), and migration. Demographic analysis examines and measures

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828-742: A validated clinical tool. The two most widely used are the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC). There are translations of these tools in over 20 languages and they are used globally in many ICU's. Nurses are the largest group of healthcare professionals working in ICUs. There are findings which have demonstrated that nursing leadership styles have impact on ICU quality measures particularly structural and outcomes measures. In

897-405: A variety of areas where researchers want to know how populations of social actors can change across time through processes of birth, death, and migration . In the context of human biological populations, demographic analysis uses administrative records to develop an independent estimate of the population. Demographic analysis estimates are often considered a reliable standard for judging

966-499: A variety of demographic methods for modelling population processes. They include models of mortality (including the life table , Gompertz models , hazards models , Cox proportional hazards models , multiple decrement life tables , Brass relational logits), fertility (Hermes model, Coale -Trussell models, parity progression ratios ), marriage (Singulate Mean at Marriage, Page model), disability ( Sullivan's method , multistate life tables), population projections ( Lee-Carter model ,

1035-514: A wide array of drugs to treat the primary condition(s) of hospitalization. Medically induced comas , analgesics , and induced sedation are common ICU tools needed and used to reduce pain and prevent secondary infections . The available data suggests a relation between ICU volume and quality of care for mechanically ventilated patients. After adjustment for severity of illnesses, demographic variables, and characteristics of different ICUs (including staffing by intensivists), higher ICU staffing

1104-417: Is because developed countries have proportionally more older people, who are more likely to die in a given year, so that the overall mortality rate can be higher even if the mortality rate at any given age is lower. A more complete picture of mortality is given by a life table , which summarizes mortality separately at each age. A life table is necessary to give a good estimate of life expectancy. Suppose that

1173-489: Is generally present to deal with the average emergency situation. Emergency medicine physicians and anaesthesiologists have training to deal with most medical emergencies, and maintain CPR and Advanced Cardiac Life Support (ACLS) certifications. In disasters or complex emergencies, most hospitals have protocols to summon on-site and off-site staff rapidly. Both emergency department and inpatient medical emergencies follow

1242-431: Is likely to continue to rise. Populations can change through three processes: fertility, mortality, and migration. Fertility involves the number of children that women have and is to be contrasted with fecundity (a woman's childbearing potential). Mortality is the study of the causes, consequences, and measurement of processes affecting death to members of the population. Demographers most commonly study mortality using

1311-550: Is seen as the intellectual father of ideas of overpopulation and the limits to growth. Later, more sophisticated and realistic models were presented by Benjamin Gompertz and Verhulst . In 1855, a Belgian scholar Achille Guillard defined demography as the natural and social history of human species or the mathematical knowledge of populations, of their general changes, and of their physical, civil, intellectual, and moral condition. The period 1860–1910 can be characterized as

1380-554: Is the case in much of the developing world, and most of historical demography . One of these techniques in contemporary demography is the sister method, where survey researchers ask women how many of their sisters have died or had children and at what age. With these surveys, researchers can then indirectly estimate birth or death rates for the entire population. Other indirect methods in contemporary demography include asking people about siblings, parents, and children. Other indirect methods are necessary in historical demography. There are

1449-432: Is today widely taught in many universities across the world, attracting students with initial training in social sciences, statistics or health studies. Being at the crossroads of several disciplines such as sociology , economics , epidemiology , geography , anthropology and history , demography offers tools to approach a large range of population issues by combining a more technical quantitative approach that represents

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1518-510: Is used in a wide variety of contexts. For example, it is often used in business plans, to describe the population connected to the geographic location of the business. Demographic analysis is usually abbreviated as DA. For the 2010 U.S. Census, The U.S. Census Bureau has expanded its DA categories. Also as part of the 2010 U.S. Census, DA now also includes comparative analysis between independent housing estimates, and census address lists at different key time points. Patient demographics form

1587-421: Is using the intercensal percentage change. The intercensal percentage change is the absolute change in population between the censuses divided by the population size in the earlier census. Next, multiply this a hundredfold to receive a percentage . When this statistic is achieved, the population growth between two or more nations that differ in size, can be accurately measured and examined. For there to be

1656-575: Is variously called an eICU , virtual ICU , or tele-ICU . Remote staff typically have access to vital signs from live monitoring systems, and telectronic health records so they may have access to a broader view of a patient's medical history. Often bedside and remote staff have met in person and may rotate responsibilities. Such systems are beneficial to intensive care units in order to ensure correct procedures are being followed for patients vulnerable to deterioration, to access vital signs remotely in order to keep patients that would have to be transferred to

1725-807: The International Union for the Scientific Study of Population , or a national association such as the Population Association of America in the United States, or affiliates of the Federation of Canadian Demographers in Canada . Population composition is the description of population defined by characteristics such as age, race , sex or marital status . These descriptions can be necessary for understanding

1794-666: The Leslie Matrix ), and population momentum ( Keyfitz ). The United Kingdom has a series of four national birth cohort studies, the first three spaced apart by 12 years: the 1946 National Survey of Health and Development , the 1958 National Child Development Study , the 1970 British Cohort Study , and the Millennium Cohort Study , begun much more recently in 2000. These have followed the lives of samples of people (typically beginning with around 17,000 in each study) for many years, and are still continuing. As

1863-516: The Middle Ages , Christian thinkers devoted much time in refuting the Classical ideas on demography. Important contributors to the field were William of Conches , Bartholomew of Lucca , William of Auvergne , William of Pagula , and Muslim sociologists like Ibn Khaldun . One of the earliest demographic studies in the modern period was Natural and Political Observations Made upon

1932-572: The United States and much of Europe ), registry statistics are the best method for estimating the number of births and deaths. A census is the other common direct method of collecting demographic data. A census is usually conducted by a national government and attempts to enumerate every person in a country. In contrast to vital statistics data, which are typically collected continuously and summarized on an annual basis, censuses typically occur only every 10 years or so, and thus are not usually

2001-666: The life table , a statistical device that provides information about the mortality conditions (most notably the life expectancy) in the population. Migration refers to the movement of persons from a locality of origin to a destination place across some predefined, political boundary. Migration researchers do not designate movements 'migrations' unless they are somewhat permanent. Thus, demographers do not consider tourists and travellers to be migrating. While demographers who study migration typically do so through census data on place of residence, indirect sources of data including tax forms and labour force surveys are also important. Demography

2070-433: The social dynamics from historical and comparative research. This data is often compared using a population pyramid . Population composition is also a very important part of historical research. Information ranging back hundreds of years is not always worthwhile, because the numbers of people for which data are available may not provide the information that is important (such as population size ). Lack of information on

2139-751: The Application of Probabilities to Life Contingencies (1838). In 1755, Benjamin Franklin published his essay Observations Concerning the Increase of Mankind, Peopling of Countries, etc. , projecting exponential growth in British colonies . His work influenced Thomas Robert Malthus , who, writing at the end of the 18th century, feared that, if unchecked, population growth would tend to outstrip growth in food production, leading to ever-increasing famine and poverty (see Malthusian catastrophe ). Malthus

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2208-564: The Bills of Mortality (1662) by John Graunt , which contains a primitive form of life table . Among the study's findings were that one-third of the children in London died before their sixteenth birthday. Mathematicians, such as Edmond Halley , developed the life table as the basis for life insurance mathematics. Richard Price was credited with the first textbook on life contingencies published in 1771, followed later by Augustus De Morgan , On

2277-487: The United Kingdom in 2003–04, the average cost of funding an intensive care unit was: Some hospitals have installed teleconferencing systems that allow doctors and nurses at a central facility (either in the same building, at a central location serving several local hospitals, or in rural locations another more urban facility) to collaborate with on-site staff and speak with patients (a form of [telemedicine]). This

2346-543: The United States, up to 20% of hospital beds can be labelled as intensive-care beds; in the United Kingdom, intensive care usually will comprise only up to 2% of total beds. This high disparity is attributed to admission of patients in the UK only when considered the most severely ill. Intensive care is an expensive healthcare service. A recent study conducted in the United States found that hospital stays involving ICU services were 2.5 times more costly than other hospital stays. In

2415-425: The accuracy of the census information gathered at any time. In the labor force , demographic analysis is used to estimate sizes and flows of populations of workers; in population ecology the focus is on the birth, death, migration and immigration of individuals in a population of living organisms, alternatively, in social human sciences could involve movement of firms and institutional forms. Demographic analysis

2484-467: The basic demographic equation holds true by definition, in practice the recording and counting of events (births, deaths, immigration, emigration) and the enumeration of the total population size are subject to error. So allowance needs to be made for error in the underlying statistics when any accounting of population size or change is made. The figure in this section shows the latest (2004) UN ( United Nations ) WHO projections of world population out to

2553-496: The basic protocol of Advanced Cardiac Life Support. Irrespective of the nature of the emergency, adequate blood pressure and oxygenation are required before the cause of the emergency can be eliminated. Possible exceptions include the clamping of arteries in severe hemorrhage . While the golden hour is a trauma treatment concept, two emergency medical conditions have well-documented time-critical treatment considerations: stroke and myocardial infarction (heart attack). In

2622-696: The best source of data on births and deaths. Analyses are conducted after a census to estimate how much over or undercounting took place. These compare the sex ratios from the census data to those estimated from natural values and mortality data. Censuses do more than just count people. They typically collect information about families or households in addition to individual characteristics such as age, sex, marital status, literacy/education, employment status, and occupation, and geographical location. They may also collect data on migration (or place of birth or of previous residence), language, religion, nationality (or ethnicity or race), and citizenship. In countries in which

2691-401: The case of stroke, there is a window of three hours within which the benefit of thrombolytic drugs outweighs the risk of major bleeding. In the case of a heart attack, rapid stabilization of fatal arrhythmias can prevent sudden cardiac arrest. In addition, there is a direct relationship between time-to-treatment and the success of reperfusion (restoration of blood flow to the heart), including

2760-518: The category of standardization , there are two major approaches: direct standardization and indirect standardization. A stable population does not necessarily remain fixed in size. It can be expanding or shrinking. The crude death rate as defined above and applied to a whole population can give a misleading impression. For example, the number of deaths per 1,000 people can be higher in developed nations than in less-developed countries, despite standards of health being better in developed countries. This

2829-553: The core of the data for any medical institution, such as patient and emergency contact information and patient medical record data. They allow for the identification of a patient and their categorization into categories for the purpose of statistical analysis. Patient demographics include: date of birth , gender , date of death , postal code, ethnicity, blood type , emergency contact information, family doctor, insurance provider data, allergies , major diagnoses and major medical history. Formal demography limits its object of study to

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2898-498: The core of the discipline with many other methods borrowed from social or other sciences. Demographic research is conducted in universities, in research institutes, as well as in statistical departments and in several international agencies. Population institutions are part of the CICRED (International Committee for Coordination of Demographic Research) network while most individual scientists engaged in demographic research are members of

2967-528: The development of demography and to the toolkit of methods and techniques of demographic analysis. Demography is the statistical and mathematical study of the size, composition, and spatial distribution of human populations and how these features change over time. Data are obtained from a census of the population and from registries: records of events like birth , deaths , migrations, marriages, divorces , diseases, and employment . To do this, there needs to be an understanding of how they are calculated and

3036-405: The dimensions and dynamics of populations; it can cover whole societies or groups defined by criteria such as education , nationality , religion , and ethnicity . Educational institutions usually treat demography as a field of sociology , though there are a number of independent demography departments. These methods have primarily been developed to study human populations, but are extended to

3105-649: The distribution and abundance of organisms. As it relates to organizations and demography, organizations go through various liabilities to their continued survival. Hospitals, like all other large and complex organizations are impacted in the environment they work. For example, a study was done on the closure of acute care hospitals in Florida between a particular time. The study examined effect size, age, and niche density of these particular hospitals. A population theory says that organizational outcomes are mostly determined by environmental factors . Among several factors of

3174-441: The emergency occurs whilst in hospital under medical care, or outside medical care (for instance, in the street or alone at home). For emergencies starting outside medical care, a key component of providing proper care is to summon the emergency medical services (usually an ambulance ), by calling for help using the appropriate local emergency telephone number , such as 999 , 911 , 111 , 112 or 000 . After determining that

3243-408: The family. The causes of turnover can be split into two separate factors, one linked with the culture of the organization, and the other relating to all other factors. People who do not fully accept a culture might leave voluntarily. Or, some individuals might leave because they fail to fit in and fail to change within a particular organization. A basic definition of population ecology is a study of

3312-534: The heart. In 1955, William Mosenthal, a surgeon at the Dartmouth-Hitchcock Medical Center also opened an early intensive care unit. In the 1960s, the importance of cardiac arrhythmias as a source of morbidity and mortality in myocardial infarctions (heart attacks) was recognized. This led to the routine use of cardiac monitoring in ICUs, especially after heart attacks. Hospitals may have various specialized ICUs that cater to

3381-513: The incident is a medical emergency (as opposed to, for example, a police call), the emergency dispatchers will generally run through a questioning system such as AMPDS in order to assess the priority level of the call, along with the caller's name and location. Those who are trained to perform first aid can act within the bounds of the knowledge they have, whilst awaiting the next level of definitive care. Those who are not able to perform first aid can also assist by remaining calm and staying with

3450-462: The injured or ill person. A common complaint of emergency service personnel is the propensity of people to crowd around the scene of a victim, as it is generally unhelpful, making the patient more stressed, and obstructing the smooth working of the emergency services. If possible, first responders should designate a specific person to ensure that the emergency services are called. Another bystander should be sent to wait for their arrival and direct them to

3519-418: The measurement of population processes, while the broader field of social demography or population studies also analyses the relationships between economic, social, institutional, cultural, and biological processes influencing a population. Demographic thoughts traced back to antiquity, and were present in many civilisations and cultures, like Ancient Greece , Ancient Rome , China and India . Made up of

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3588-413: The nation will become a nation of immigrants. This influx is projected to rise over the next century as new immigrants and their children will account for over half the U.S. population. These demographic shifts could ignite major adjustments in the economy, more specifically, in labor markets. People decide to exit organizations for many reasons, such as, better jobs, dissatisfaction, and concerns within

3657-458: The original data-collection procedures may prevent accurate evaluation of data quality. The demographic analysis of labor markets can be used to show slow population growth, population aging , and the increased importance of immigration. The U.S. Census Bureau projects that in the next 100 years, the United States will face some dramatic demographic changes. The population is expected to grow more slowly and age more rapidly than ever before and

3726-448: The patient or terminate care until a responder of equal or higher training (such as an emergency medical technician ) assumes care. This can constitute abandonment of the patient and may subject the responder to legal liability. Care must be continued until the patient is transferred to a higher level of care; the situation becomes too unsafe to continue; or the responder is physically unable to continue due to exhaustion or hazards. Unless

3795-516: The prefix demo- and the suffix -graphy , the term demography refers to the overall study of population. In ancient Greece, this can be found in the writings of Herodotus , Thucydides , Hippocrates , Epicurus , Protagoras , Polus , Plato and Aristotle . In Rome, writers and philosophers like Cicero , Seneca , Pliny the Elder , Marcus Aurelius , Epictetus , Cato , and Columella also expressed important ideas on this ground. In

3864-594: The proper location. Additional bystanders can be helpful in ensuring that crowds are moved away from the ill or injured patient, allowing the responder adequate space to work. To prevent the delay of life-saving aid from bystanders, many states of the USA have " Good Samaritan laws " which protect civilian responders who choose to assist in an emergency. In many situations, the general public may delay giving care due to fear of liability should they accidentally cause harm. Good Samaritan laws often protect responders who act within

3933-566: The questions they answer which are included in these four concepts: population change , standardization of population numbers, the demographic bookkeeping equation, and population composition. There are two types of data collection —direct and indirect—with several methods of each type. Direct data comes from vital statistics registries that track all births and deaths as well as certain changes in legal status such as marriage, divorce, and migration (registration of place of residence). In developed countries with good registration systems (such as

4002-417: The same sources of change. When dealing with ethnic groups, however, "net migration" might have to be subdivided into physical migration and ethnic reidentification ( assimilation ). Individuals who change their ethnic self-labels or whose ethnic classification in government statistics changes over time may be thought of as migrating or moving from one population subcategory to another. More generally, while

4071-447: The samples have been drawn in a nationally representative way, inferences can be drawn from these studies about the differences between four distinct generations of British people in terms of their health, education, attitudes, childbearing and employment patterns. Indirect standardization is used when a population is small enough that the number of events (births, deaths, etc.) are also small. In this case, methods must be used to produce

4140-416: The scope of their knowledge and training, as a "reasonable person" in the same situation would act. The concept of implied consent can protect first responders in emergency situations. A first responder may not legally touch a patient without the patient's consent. However, consent may be either expressed or implied : Usually, once care has begun, a first responder or first aid provider may not leave

4209-464: The situation is particularly hazardous and is likely to further endanger the patient, evacuating an injured victim requires special skills, and should be left to the professionals of the emergency medical and fire service. During a medical emergency in which a patient is no longer breathing and does not have a pulse , survival is predicated on adherence to the chain of survival , which has four components: Within hospital settings, an adequate staff

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4278-479: The surgery is very invasive and the patient is at high risk of complications. In 1854, Florence Nightingale left for the Crimean War , where triage was used to separate seriously wounded soldiers from those with non-life-threatening conditions. Until recently, it was reported that Nightingale's method reduced mortality from 40% to 2% on the battlefield. Although this was not the case, her experiences during

4347-404: The theory, there are four that apply to the hospital closure example: size, age, density of niches in which organizations operate, and density of niches in which organizations are established. Problems in which demographers may be called upon to assist business organizations are when determining the best prospective location in an area of a branch store or service outlet, predicting the demand for

4416-484: The victim themselves. Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from first aiders through emergency medical technicians , paramedics , emergency physicians and anesthesiologists . Any response to an emergency medical situation will depend strongly on the situation, the patient involved, and availability of resources to help them. It will also vary depending on whether

4485-478: The vital registration system may be incomplete, the censuses are also used as a direct source of information about fertility and mortality; for example, the censuses of the People's Republic of China gather information on births and deaths that occurred in the 18 months immediately preceding the census. Indirect methods of collecting data are required in countries and periods where full data are not available, such as

4554-467: The war formed the foundation for her later discovery of the importance of sanitary conditions in hospitals, a critical component of intensive care. In response to a polio epidemic (where many patients required constant ventilation and surveillance), Bjørn Aage Ibsen established the first intensive care unit globally in Copenhagen in 1953. The first application of this idea in the United States

4623-533: The year 2150 (red = high, orange = medium, green = low). The UN "medium" projection shows world population reaching an approximate equilibrium at 9 billion by 2075. Working independently, demographers at the International Institute for Applied Systems Analysis in Austria expect world population to peak at 9 billion by 2070. Throughout the 21st century, the average age of the population

4692-457: Was in 1951 by Dwight Harken . Harken's concept of intensive care has been adopted worldwide and has improved the chance of survival for patients. He opened the first intensive care unit in 1951. In the 1960s, he developed the first device to help the heart pump. He also implanted artificial aortic and mitral valves. He continued to pioneer in surgical procedures for operating on the heart. He established and worked in several organizations related to

4761-494: Was significantly associated with lower ICU and hospital mortality rates . A ratio of 2 patients to 1 nurse is recommended for a medical ICU, which contrasts to the ratio of 4:1 or 5:1 typically seen on medical floors. This varies from country to country, though; e.g., in Australia and the United Kingdom, most ICUs are staffed on a 2:1 basis (for high-dependency patients who require closer monitoring or more intensive treatment than

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