Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Mar 2008
ReviewEmergency medical support units to critical care transport teams in Iraq.
Early in the author's deployment in the United States Air Force to southern Iraq, his unit was exposed to the first of many mass casualties sent to his Expeditionary Medical Support System unit. Within minutes of the injured military members' arrival, the four-bed evaluation station was transformed into an open bay trauma room where patients were treated and supported until they could be evacuated to more definitive care. Patients were transitioned with awe-inspiring speed and professionalism to Critical Care Air Transport teams for care during aeromedical evacuation. The lessons learned from the frequency of these events are valuable to any similar transport case with critically ill and injured patients.
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Crit Care Nurs Clin North Am · Mar 2008
ReviewMilitary nursing research: translation to disaster response and day-to-day critical care nursing.
Where to begin? How do you identify nursing care requirements for military operations, disaster, and humanitarian response, and how do you modify care under these unique conditions? This article presents a framework for identifying areas of critical care nursing that are performed on a day-to-day basis that may also be provided during a contingency operation, and discusses how that care may be changed by the austere conditions associated with a contingency response. Examples from various disasters, military operations, and military nursing research are used to illustrate the use of this framework. Examples are presented of how the results of this military nursing research inform disaster nursing and day-to-day critical care nursing practice.
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Crit Care Nurs Clin North Am · Mar 2008
ReviewNutrition support of the traumatically injured warfighter.
Major trauma induces metabolic alterations that contribute to the systemic immune suppression in severely injured patients and increase the risk of infection and posttraumatic organ failure. Nutrition modulation of cellular processes has evolved into a high-priority therapy, backed by substantial scientific evidence. The appropriate selection, timing, and dose of nutrients required for metabolic resuscitation must be individualized and goal directed. Ideally, the nutritional interventions for warfighters will be developed strategically based on the extent of injuries and underlying deficiencies and will be designed to provide the nutrients necessary to balance hypermetabolic processes, heal wounds, and promote optimal recovery.
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Traumatic amputees may experience a variety of acute and chronic pain issues, including phantom limb pain and residual limb pain. Research continues to determine the causes of these problems and to find the most appropriate and effective treatments for each of these phenomena. It is important for health care providers to be knowledgeable about the variety of treatments available, including medications, surgical procedures, complementary and alternative therapies, and self-treatment methods to ensure that amputees receive the best practices for individualized, effective pain management that they deserve.
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Crit Care Nurs Clin North Am · Mar 2008
Case ReportsThe Synergy Model at work in a military ICU in Iraq.
The Synergy Model for Patient Care, developed by the American Association of Critical-Care Nurses (AACN), demonstrates that positive patient outcomes are achieved when patient characteristics are matched with nurse competencies. Through the vivid realities in the daily journal of a military ICU nurse taking care of patients in Iraq, a virtual triad learning experience provided academic, clinical, and personal support. This article describes how effective nursing practice, whether providing direct patient care in the United States or in a military ICU in Iraq, must be centered around the needs and characteristics of patients. Acute and critically ill patients in a military ICU in Iraq have unique needs and require nurses with competent skills to help promote optimal outcomes.