Critical care nurse
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Leadless pacemakers will most likely be the future of cardiac pacing. Leadless pacing employs a single-chamber system to pace only the right ventricle and is fully self-contained, which eliminates the need for leads. These systems, implanted by using a transcatheter sheath, are indicated for patients who need right ventricular pacing only. ⋯ Leadless pacemakers also are compatible with magnetic resonance imaging and do not require surgical placement, so patients avoid postoperative mobility restrictions. Because this technology will be increasingly used for cardiac internal electronic devices, commonly seen in critical care nursing, nurses must be knowledgeable about the indications for use of a wireless pacemaker, the implantation procedure, postprocedural care, device interrogation, and follow-up. This article discusses leadless pacemakers, clinical indications for their use, key similarities and differences between the current devices being used, key points for nursing care of patients with a leadless device, and the future of this technology.
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Critical care nurse · Apr 2017
ReviewConsequences of Transfusing Blood Components in Patients With Trauma: A Conceptual Model.
Transfusion of blood components is often required in resuscitation of patients with major trauma. Packed red blood cells and platelets break down and undergo chemical changes during storage (known as the storage lesion) that lead to an inflammatory response once the blood components are transfused to patients. ⋯ The purpose of this review is to provide critical care nurses with a conceptual model to facilitate understanding of the relationship between the storage lesion and patients' outcomes after trauma; outcomes related to trauma, hemorrhage, and blood component transfusion are grouped according to those occurring in the short-term (≤30 days) and the long-term (>30 days). Complete understanding of these clinical implications is critical for practitioners in evaluating and treating patients given transfusions after traumatic injury.