Reliable prognostication at a later stage (≥4 to 5 days) is of paramount importance for decisions on level of care, including withdrawal of life-sustaining therapy in patients with presumed poor outcome (vegetative state or death).
This model has to support decisions on three levels: - At operational level, the most relevant topic is whether the organization of nursing activities is such that appropriate and efficient care can be provided.
From a practical point of view, a later maximum level of NfH SMI35 (> 1 week) is of less value for the acute prognostication and the decision on level of care.
In addition, somatosensory evoked potentials (SSEP), amplitude-integrated electroencephalogram (aEEG) and diffusion-weighted magnetic resonance imaging (DW-MRI) were added as a basis for a decision on level of care [ 10].
The decisions on force levels in Afghanistan could mirror how Mr. Obama handled the withdrawal of American troops from Iraq.
Another factor that may complicate the decisions on troop levels this fall is the anticipation of provincial elections across Iraq in October.
"We have momentum, and we must maintain this momentum," said the officer, who asked not to be identified because final decisions on troop levels for 2008 have yet to be made at the White House.
The war in Afghanistan was discussed in only general terms during the election campaign, but a series of decisions on troop levels and other issues is to be settled in the coming weeks and months.
