Siuba Matthew T, Carroll Christopher L, Farkas Joshua D, Olusanya Segun, Baker Kylie, Gajic Ognjen
Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
Connecticut Children's Medical Center, Hartford, Connecticut.
ATS Sch. 2020 Jul 14;1(3):225-232. doi: 10.34197/ats-scholar.2020-0019PS.
Evidence-based medicine asks us to integrate the best available evidence with clinical experience and patient values. In the modern intensive care unit, the primary focus is on complex technology and electronic health records, often away from the bedside. Excess interventionism is the norm. The term "intensivist" itself implies an management strategy, which can lead us away from a patient-centered practice and toward iatrogenic harm. Under the hashtag #zentensivist, an international, multiprofessional group of clinicians has begun to discuss via Twitter how to apply key principles of history taking, physical examination, physiology, pharmacology, and clinical research in a competent, compassionate, and minimalist fashion. The term "zentensivist" intentionally combines concepts seemingly at odds-Zen philosophy and intensive care-to describe a holistic approach to the art of caring for the critically ill. We describe the key tenets of zentensivist practice and how we may inspire these actions in those we lead and educate.
循证医学要求我们将最佳可得证据与临床经验及患者价值观相结合。在现代重症监护病房，主要关注点在于复杂的技术和电子健康记录，常常远离病床边。过度干预主义成为常态。“重症医学专家”这个术语本身就暗示了一种管理策略，这可能会使我们偏离以患者为中心的医疗实践，走向医源性伤害。在#zentensivist这个标签下，一个国际多专业临床医生团队已开始通过推特讨论如何以胜任、富有同情心且极简的方式应用病史采集、体格检查、生理学、药理学及临床研究的关键原则。“zentensivist”这个术语有意将看似矛盾的概念——禅宗哲学与重症监护——结合起来，以描述一种照顾重症患者的整体方法。我们描述了zentensivist实践的关键原则，以及我们如何在我们领导和教育的人中激发这些行动。
