Critical care nurse
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Critical care nurse · Dec 2016
Use of Neuromuscular Blockers During Therapeutic Hypothermia After Cardiac Arrest: A Nursing Protocol.
Neuromuscular blockers used to prevent shivering during therapeutic hypothermia in comatose patients after out-of-hospital cardiac arrest are associated with adverse events. ⋯ Use of a nurse-implemented protocol to reduce use of neuromuscular blockers is feasible.
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Critical care nurse · Dec 2016
Strategies for Acute and Critical Care Nurses Implementing Complementary Therapies Requested by Patients and Their Families.
As consumer use of complementary and alternative medicine or modalities continues to increase in the United States, requests for these therapies in the acute and critical care setting will probably continue to expand in scope and frequency. Incorporation of complementary therapies in the plan of care is consistent with principles of patient- and family-centered care and collaborative decision-making and may provide a measure of relief for the distress of admission to an acute or critical care setting. An earlier article provided an overview of complementary and alternative therapies that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses. This article provides key information on the legal, ethical, safety, quality, and financial challenges that acute and critical care nurses should consider when implementing patient and family requests for complementary therapies.
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Critical care nurse · Dec 2016
ReviewPlanning for Deactivation of Implantable Cardioverter Defibrillators at the End of Life in Patients With Heart Failure.
Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD shock. Critical care nurses should be aware of the potential burden of these shocks at the end of life as well as the ethics and organizational policies surrounding ICD deactivation. ⋯ Based on this author's findings, recommendations for discussing and implementing ICD deactivation are offered. Health care organizations should have clear policies addressing ICD deactivation to provide for seamless integration of palliative care services throughout the course of heart failure. These policies should empower nurses to activate resources in a timely manner and should clearly outline processes for ICD deactivation.