Critical care nurse
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Subarachnoid hemorrhage is an often devastating intracranial hemorrhage resulting from acute bleeding into the subarachnoid space. Although its overall incidence is less than that of acute ischemic stroke, sub-arachnoid hemorrhage carries increased risks of both mortality and disability. Although many patients with subarachnoid hemorrhage are transferred to specialty centers, they might initially present to small community-based hospitals. ⋯ Therefore, all members of the health care team who care for these patients must understand proper management. Nurses in the intensive care unit play an important role in influencing outcomes, as they are best positioned to recognize neurological decline and provide rapid intervention. This article discusses the anatomy relevant to, and the epidemiology and pathophysiology of, subarachnoid hemorrhage and provides an overview of current evidence and clinical guidelines for managing this brain injury.
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Clostridioides (formerly Clostridium) difficile infection is among the most identified causes of health care-associated infections in US hospitals and remains a major public health problem. The incidence and severity of C difficile infection are high among critically ill patients. Treating critically ill patients is challenging; treatment failure is especially common because of comorbidities and the continued need for antibiotic therapy for other infections. Because of the high risk of C difficile infection recurrence and high mortality rate associated with the disease, intensive research has taken place over the last decade to improve patient outcomes. This research has resulted in new drugs indicated for C difficile infection and new information on existing drugs. The 2010 clinical practice guidelines for C difficile infections have been updated on the basis of this new information. ⋯ The updated recommendations for the treatment of C difficile infection, the clinical pharmacology of old and new drugs for treating the infection, and the role of critical care nurses in mini-mizing the risk of C difficile infection for their patients.
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Critical care nurse · Oct 2019
Comparative StudyWhy Prone? Why Now? Improving Outcomes for ARDS Patients.