Critical care nursing clinics of North America
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Opioid analgesics are the historical mainstay for postoperative cardiothoracic surgery pain relief. Although opioids are efficacious, they are linked with adverse effects, including sedation and respiratory depression. ⋯ Preoperatively educating patients and families on expected nociception and treatment options decreases postprocedural pain. Discussing use of nonopioid analgesics for mild pain and instructions on tapering opioid medications at discharge may prevent future misuse.
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Crit Care Nurs Clin North Am · Sep 2019
ReviewCardiac Surgical Resuscitation: State of the Science.
Cardiac surgical patients risk arrest from tamponade, profound bleeding, and hypovolemia, typically occurring within hours of intensive care admission and associated with diminished response to cardiopulmonary resuscitation (CPR). The Society of Thoracic Surgeons' evidence-based Expert Consensus Statement establishes a new standard for postsurgery arrest management, prioritizing defibrillation or pacing before CPR, restricting epinephrine use, and calling for prompt resternotomy if initial efforts fail. ⋯ This US cardiac surgical resuscitation standard is aligned with worldwide guidelines. Important information for protocol adoption and training is provided.