@FlaviaSepsis

Our public hospitals

Our very nice private

hospitals

Cadastro Nacional dos Estabelecimentos de Saúde (CNES) – 2013, Agência Nacional de Saúde Suplementar (ANS) e Instituto Brasileiro de Geografia e Estatística (IBGE).

7.6 public ICU beds for 100,000 habitants

Middle-West7.4

Northeast5.0

North3.2

South9.4

Southest 10.4

25.5 private ICU beds for 100,000 habitants

Middle-West38.5

Northeast28.4

North28.8

South22.2

Southest 24.2

This means that your

chances of dying are greater!

This means that your cancer surgery has already been suspended because

we didn’t give you an ICU bed!

AND THERE ARE MORE LIKE YOU

In this afternoon the ED has 168

adult patients for 41 beds and 9 children for 9 pediatric bed.

Subtitles

Boeing B-17 Flying Fortress

A DAILY CONSEQUENCE

The pilot

The co-

pilot

I only disagree with this innovative method: speakers like TED using the same t-shirt and sitting in a chair as sessions’ moderators. We

lost the solemnity and respect for the professionals , especially the physician. Something similar with what the current Brazilian

government has made to the physicians.

Our own experience

Subtitles

ATTENTION

Desfibrilator is out-of-work!!!

ATENTION PATIENTS

PLEASE, IF YOU ARE GOING TO HAVE A CARDIAC ARREST, DO IT IN NON-

SHOCKABLE RHITMS

WE THANK YOU FOR YOUR UNDERSTANDING

TOP THINGS THAT SUCK

Procrastination from the last guy in charge

Procrastination from surgeons – “another CT scan…”, “he is too unstable…”

Paper work

Be all by yourself because your buddy fudged up

Work with bad nurses – good nurses are everything we want!

Deal with assistant physicians that don't wash their hands

Weekend shift

Team misinformation and family misinterpretation

Surgeons asking for transfusions

THE TOP IN ANY HOSPITAL

Battling for medicines

Being threatened by judicial warrant

Deciding who will get the only ICU bed

Battling for a bed in the wards

Cancelling elective surgery because you lost the battle

Begging the radiology resident for a CT scan

Getting the assistant physicians to come and see their patients

THE TOP IN PUBLIC HOSPITALS

Dealing with assistant physicians

Admitting patients in the early hours of the morning without ANY ICU INDICATION

Waiting for health insurance company approval for exams and procedures

Answering audit from the heath insurance companies

THE TOP IN PRIVATE HOSPITALS

think they are intensivists

think they are god

don’t want patients under EOL care

put the patient in the ICU because he is unable to discuss EOL with the family

decide in a holiday that patients is not ready for discharge

tell family everything is all right

wants to talk about amenities when you shift is a battle camp

Deal with assistant physicians who:

THE TOP IN PRIVATE HOSPITALS

ECMO!!????

OR1,250 g meropenem = 416 treatment-days?

OUR FIRST ECMO!!!

1,250 g meropenem in less then 24 hours...

Some times it is just too

much...

Futility?