ABSTRACT
It has been stated that ‘The most sophisticated intensive care often becomes unnecessarily expensive terminal care when the pre-ICU system fails.’ The mortality rate following inhospital cardiac arrests is high, with only 15% survival at 1 year. Adverse events such as cardiac arrest, unexpected death and unanticipated critical care admission are common and seen in anything from 4 to 17% of admissions. Analyses of such events show that many of them are predictable and preventable. Up to 80% of patients with in-hospital cardiac arrest have changes in vital signs within 8h before arrest and up to 41% of admissions to critical care units are potentially avoidable. Intensive care medicine has been largely practised within the four walls of the critical care unit.
