Critical care nursing quarterly
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Resuscitation of major trauma victims suffering from shock remains a challenge for trauma systems and trauma centers. Rapid identification, and ensuring correct, aggressive treatment, are necessary for patient survival. ⋯ The critical care nurse plays an important role as part of the team involved in the resuscitation and ongoing care of these patients. Understanding the underlying pathophysiology, recognizing signs and symptoms, and being prepared to effectively respond will further enable the nurse to contribute to positive patient outcomes.
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Orthopedic trauma is frequently encountered by critical care nurses as trauma team members providing care to the severely injured. Through actual case examples, the role of the critical care nurse and orthopedic trauma management is reviewed. Focus is on unstable pelvic fractures, extremity fractures, compartment syndrome, rhabdomyolysis, mangled extremities, gunshot-wound fractures, and damage-control orthopedics.
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This article is an overview of abdominal trauma relating to both penetrating and blunt mechanisms of injury. The incidence of abdominal injuries is discussed. Illustrated through case studies are interventions and treatment applicable to nursing practice. ⋯ Anatomy and physiology of the different organ systems, as well as complications, is briefly overviewed. Differences between solid and hollow organs are reviewed. Pearls and pitfalls that impact nursing practice are presented for specific injuries.
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ARDS or acute respiratory distress syndrome continues to be a considerable critical care challenge. Mortality has not decreased significantly over the last more than 30 years. This article presents an overview of origin, evaluation, and treatment of ARDS. ⋯ Clinical and radiologic descriptors in assessment of the patient with ARDS are discussed. Ventilatory modes and nursing interventions to optimize patient outcomes are identified. The challenges of outcomes issues presented offer opportunities for further study.
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Respiratory failure is defined as a failure in gas exchange due to an impaired respiratory system--either pump or lung failure, or both. The hallmark of respiratory failure is impairment in arterial blood gases. ⋯ The possible causes of respiratory failure are then briefly mentioned and a quick reference to the clinical evaluation of such patients is made. Finally treatment options are briefly outlined for both acute and chronic respiratory failure.