Chest
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Review
Transforming team culture through curiosity and collaboration: a case study from critical care.
Interprofessional team conflict amplifies division and impedes patient care. Normal differences of opinion escalate to frank conflicts when members respond with indignation or resentment. These behaviors engender a workplace culture that degrades collaborative clinical management and patient safety. ⋯ This exercise supports interprofessional teams to transform dysfunctional interactions by helping team members to develop a mindset of humility and inquiry and to remind themselves about the good intentions in others. To address conflict, we offer a conversational approach grounded in curiosity, respect, and transparency. Ultimately, the most important communication strategy for effective critical care is caring about the perspectives and experiences of other members of the interprofessional team.
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Although interstitial lung disease (ILD) is a leading cause of morbidity and mortality in patients with inflammatory myopathies, the current definition and diagnostic criteria of autoimmune myositis remain inadequate to capture the large proportion of patients with lung-dominant disease. As a result, these patients present unique diagnostic and treatment challenges for even the most experienced clinicians. This article highlights the emerging role of autoantibodies in the diagnosis, classification, and management of patients with ILD. ⋯ Additionally, evidence supporting the various therapies used in the treatment of myositis-associated ILD is reviewed. The classification and treatment of patients with myositis-associated ILD remains challenging. A standardized therapeutic approach to these patients is lacking, and prospective studies in the field are needed to determine optimal treatment regimens.
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Comment Case Reports
Potassium Chloride-Induced Phlebitis via a Malpositioned Central Venous Catheter.
We present a case of potassium chloride-induced phlebitis with severe, burning, left-sided chest pain when infused via a malpositioned central venous catheter. Using a malpositioned central venous catheter requires careful consideration, but this novel case prompts the need for additional review before its use for the infusion of potentially irritating medications.