Heart & lung : the journal of critical care
-
The endotracheal route for medication is useful in emergency situations. Epinephrine, atropine, and naloxone have proved to be effective when administered by this route. Experience with lidocaine is largely anecdotal, but the available information and the drug's chemical properties indicate that endotracheal lidocaine may be considered if necessary. Drugs that should not be given by the endotracheal route include bretylium, diazepam, calcium salts, isoproterenol, norepinephrine, and sodium bicarbonate.
-
The thermodilution method of measuring cardiac output has a firm scientific basis and provides data to assist clinicians in assessing the hemodynamic function of patients and evaluating therapeutic interventions. Most of the research that validated this method of measurement was conducted from 1954 to 1979. Research in the 1980s focuses primarily on refining measurement techniques evaluating protocols that will simplify measurements in the clinical setting, and testing new devices that have the potential for affecting the accuracy of measurements. Although discrepancies between theory and application took years to resolve resulting in initial resistance to this method, thermodilution cardiac output measurement is now well accepted by researchers and clinicians as safe, simple, and accurate.
-
Thousands of health care providers spend time, money, and energy each year taking the AHA-sponsored ACLS courses, and ACLS-certified health care providers are frequently given greater job responsibility than other health care providers in the same setting. The purpose of this study was to determine the effect of an ACLS course on the ability of health care providers to perform ACLS in a simulated situation. A nonequivalent control group design was used. ⋯ The Mega-Code skill station from the ACLS course was used to evaluate ACLS performance. Chi-square analyses showed a significant (p less than 0.05) difference in the posttest pass/fail results of the two groups and a significant (p less than 0.05) difference in the changes from pretest to posttest of the two groups. The research hypotheses were supported, and the researches concluded that the course had a positive effect on the subjects' ACLS ability.
-
A successful outcome for the patient who hemorrhages after surgery is based on the recognition of bleeding, the specific diagnosis of bleeding sites and disorders, and the management of bleeding by control measures and replacement of blood lost (Table III). The best preventative measures include careful preoperative assessment of historical and physical findings along with appropriate laboratory tests.