Heart & lung : the journal of critical care
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To summarize and evaluate evidence on the psychometric properties of the Glasgow Coma Scale (GCS). ⋯ In spite of its acknowledged shortcomings and the emergence of parallel instruments with greater reliability and validity, the GCS continues to enjoy a privileged, but unwarranted, position in clinical and investigational contexts.
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To enable vocalization in a tracheostomized ventilator-assisted patient without compromising pulmonary status. ⋯ During each session, the patient was able to vocalize clearly, without complications, as measured by the physiologic parameters: heart rate, respiratory rate, blood pressure, and oxygen saturation determined by oximetry.
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To determine the most accurate technique to measure the heart rate during atrial fibrillation by use of three counting intervals, 15, 30, and 60 seconds, and two methods, apical and radial pulse measurement. ⋯ Atrial fibrillation occurs in 2% to 4% of people over 60 years of age and is one of the most difficult dysrhythmias to count. Accurate counts are important when making clinical decisions, yet measurement of heart rate in this study was quite inaccurate. The 60-second count and the apical method were the most accurate statistically, although differences in counting interval error rates were not clinically significant.
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To compare the degree of dyspnea experienced by ventilator-dependent patients receiving synchronized intermittent mandatory ventilation (SIMV) versus T-piece or pressure support ventilation (PSV) weaning. The relationship between self-reported perceptions of dyspnea and physiologic variables observed during weaning trials was examined. Variables included heart rate, respiratory rate, minute ventilation, and oxygen saturation as measured by a pulse oximeter. ⋯ The patient's experience of dyspnea during the weaning process can be a valuable guide to observe the patient's progress. The VAS serves as a reliable, easy-to-use tool for quantifying the patient's perception of dyspnea.
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Massive community efforts are devoted to delivering cardiopulmonary resuscitation (CPR) training to health professionals and lay people. However, although most people can successfully learn to perform CPR, skills retention is universally poor. ⋯ The failure of many factors to improve retention of CPR skills is discussed. Finally, suggestions for improvement in retention of CPR skills based on a review of the literature and pertinent theory are offered.