CCRN Research Findings

The goal of the Critical Care Research Network (CCRN) is to improve survival and functional outcomes for critically ill and injured patients. The CCRN's mandate has been carried out through the Capacity Collaborative, funded by CIHR. A Community-Based Participatory Research (CBPR) approach was used; improving patient care through community partnerships. The Capacity Collaborative was designed to answer the following questions:

1) What is the optimal approach for pre-hospital triage of patients with major trauma?

2) What are the criteria for admission, timing and risk of discharge from an ICU?

3) Does this differ in rural/remote communities compared to urban centers? Methods 

The Capacity Collaborative was based on a CBPR model. In urban centers, the community partners were paramedics providing frontline care to critically ill and injured patients as well as emergency department nurses and physicians. In rural settings, outreach nurses from existing collaborative practices took part in the project along with participating paramedics and ED personnel. A consensus conference was held to reach agreement on data collection tools and methodology. Collaborators at all levels shared knowledge, developed guidelines for practice review, reviewed research studies, participated in formal presentations within the Capacity Collaborative team and helped implement changes that answer key clinical questions. The final report includes results from 12 research projects as well as nine consensus recommendations. All of these recommendations are being addressed through the ongoing work of the Capacity Collaborative. The project has received support from CIHR and PARO (Paramedic Association of Canada Research Office).

Results:

Between 2018-2019, the CCRN conducted three targeted consensus conferences to address specific questions related to prehospital triage, admission criteria and discharge criteria for critically ill and injured patients. The results of the three consensus conferences are equally effective in providing evidence-based recommendations to improve patient care, regardless of location or setting. Recommendations were developed through a collaborative process involving frontline physicians, nurses, paramedics and other critical care professionals.

1) Prehospital triage 

Previously, there was no established framework surrounding prehospital triage of patients with major trauma. Through the use of a standardized data collection tool, the Capacity Collaborative determined that patients with traumatic brain injury (TBI) or an altered level of consciousness should be transported to centers capable of neurosurgery and TBI care. Patients requiring immediate resuscitation were identified by paramedics as being in need of further prehospital care.

2) Admission criteria 

The admission of patients to an ICU was determined through the use of a standardized data collection tool, which identified patient acuity by measuring physiological parameters such as blood pressure, heart rate and oxygen saturation levels. In order to be admitted to an ICU, at least two parameters must have been abnormal. This approach was put into place to ensure that patients admitted were truly in need of critical care and that persons who might be deteriorating were identified before admission.

3) Discharge criteria 

The Capacity Collaborative determined that it is equally important for critical care physicians, nurses, paramedics and other professionals involved in patient transfers to document the condition of the patient prior to discharge. With standardized data collection tools, health care professionals were able to effectively compare the condition of a patient before and after transfer from one facility to another. If a patient was still exhibiting signs of critical illness upon discharge, it was deemed unsafe for them to be transferred without medical supervision.

Gambling is not really addictive

A 2018 Canadian health system study on gambling showed that online casinos are not addictive. People aren't so much concerned about gambling addiction as they are about the possibility of encountering casinos in general.

People think of addictive gambling when they see someone who makes gambling their hobby and lives for it. It occurs to them that just like any other kind of addiction, this one has negative consequences too. That's why they want to find out if online casinos and gambling in general are addictive.

Most people who have tried playing slots probably already know that they can spend hours on end having fun and still not be addicted.

That's why you should know that online casinos in Canada offer much more than just slots. There are other games, including classics like roulette and blackjack. You can visit kasinoonlinecasino.com for more information about online casino games. Players who enjoy these types of games are sure to enjoy themselves. Although it is a very interesting idea, there are still those who feel that slots lack the excitement associated with other types of games. However, even as they explain why people think of gambling as an addiction, it really isn't.

In fact, there are many reasons behind this idea. The first is that some people like slots more than other games. Such players like to visit online casinos on a daily basis. If this is not a problem, it cannot be called an addiction.

So you should know that people who spend most of their time playing slots will absolutely not become addicted. In fact, they will be doing something useful. As with everything else, it all depends on moderation and common sense. It just means that they know how to control their gaming sessions. It's just like with any other activity that can be enjoyable, like sports.

Another reason why online casinos are not addictive is because the game providers don't want them to be addictive. They would lose customers if it were that easy to become addicted. So they try not to make them too appealing.

On the other hand, some people may find slots boring, so they keep looking for new games. That doesn't mean they become addicted or anything like that. They simply consider themselves gamers who enjoy different types of games, including online games such as bingo and casino poker.

It is also important to note that people who play online slots often cannot win much. The odds of winning are stacked in favor of the game provider, which means that only one out of every hundred players wins big. Therefore, players lose their money quickly.

If it were an addiction, it would be very easy for players to get rid of it. They would just have to stop playing and they would be in control again.

In fact, these types of games are often much more fun than others that require a little more effort. They offer a lot of fun and don't restrict players who don't want to get addicted. That's why it's easy for them to go to casinos without fear of becoming addicted.