Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · Mar 2014
Validation of the critical-care pain observation tool in adult critically ill patients.
Effective management of pain begins with accurate assessment of its presence and severity, which is difficult in critically ill patients. The Critical-Care Pain Observation Tool (CPOT) was developed to evaluate behaviors associated with pain and validated primarily with cardiac surgical patients. ⋯ The CPOT is an acceptable behavioral pain assessment scale for use in the general critical care patient population and is more appropriate for use with adults than the FLACC.
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Dimens Crit Care Nurs · Mar 2014
ReviewGlucose management in critically ill medical and surgical patients.
Currently, many providers treat hyperglycemia in the critically ill based on guidelines suggesting target glucose ranges between 140 and 180 mg/dL. However, recent literature has attempted to challenge this by comparing the effect of intensive insulin therapy (IIT) to conventional insulin therapy. ⋯ Factors such as days of mechanical ventilation, infection rates, length of stay in the ICU, and incidence of organ failure were included as secondary end points. The data suggest IIT may improve patient outcomes in some areas, but the data are not statistically significant, and adoption of an IIT protocol is not recommended at this time.