The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Transport of critically ill intensive care unit (ICU) patients may be hazardous. In this study, we examined the use of a portable head CT scanner (CereTom) in the ICU to assess its feasibility, safety, and radiological quality. Two hundred and twenty-five portable head CT scans were obtained from 114 patients (mean age = 57 +/- 18 years) treated in a neurosurgical intensive care unit at a university-based Level I trauma center. ⋯ The average total time to perform a portable head CT scan was 19.5 +/- 3.5 min. The actual scan time was 2.5 +/- 0.7 min. These results suggest that the portable CT scanner (CereTom) is feasible, easy to use, and safe and provides adequate radiological quality for diagnostic decisions.
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Neuroscience intensive care unit (ICU) nurses deliver a number of interventions when caring for critically ill traumatic brain injury (TBI) patients. Yet, there is little research evidence documenting specific nursing interventions performed. As part of a larger study investigating ICU nurse judgments about secondary brain injury, ICU nurses were asked to identify interventions routinely performed when caring for TBI patients. ⋯ Nurses were responsible for monitoring intracranial pressure and cerebral perfusion pressure approximately 50% of the time. Qualitative analyses revealed that additional nursing interventions could be categorized as neurophysiological interventions, psychosocial interventions, injury prevention interventions, and interventions to maintain a therapeutic milieu. Findings from this study provide evidence of the multifaceted role of the neuroscience ICU nurse caring for TBI patients and can be used in future research investigating the impact of nursing interventions on patient outcomes.
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Despite stroke being the third leading cause of death and a leading cause of disability in the United States, less than 7% of stroke survivors receive tissue plasminogen activator (tPA) in the treatment of acute stroke. The purpose of this review was to determine what research is available on barriers to tPA use and to determine gaps in the literature. A search of the literature was conducted using Medline, Cumulative Index to Nursing and Allied Health Literature, Embase, and PubMed. ⋯ Prehospital delays were related to contacting primary care physicians, mode of arrival to the hospital, and survivors' lack of knowledge regarding stroke. Sources of in-hospital delays included non-stroke center status, lack of training of emergency department staff, delays in computed tomography scans, and poor understanding regarding priority stroke treatment (e.g., mild or improving symptoms and disparities related to age, gender, and race). Future research to evaluate the impact of nursing care and attitudes toward stroke patients on the administration of tPA is recommended.
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Ischemic stroke accounts for 87% of the 780,000 strokes occurring annually in the United States and is a leading cause of death and functional limitations worldwide. The prompt recognition of stroke symptoms and timely arrival at the emergency room are important to stroke outcomes. Recent literature was suggestive that women may have different stroke symptoms compared with men. ⋯ Overall, the extant research was not indicative of robust gender differences in the classic symptoms of stroke or a greater frequency of nontraditional symptoms in women. One study found that women were significantly more likely than men to report nonspecific "somatic" symptoms, and in another study women were significantly more likely to have a change in mental status compared with men. Implications for nursing practice and suggestions for future research are discussed.