Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2014
ReviewTherapeutic hypothermia after cardiac arrest and return of spontaneous circulation: it's complicated.
Providing evidence-based care to patients with return of spontaneous circulation after a cardiac arrest is a recent complex innovation. Once resuscitated patients must be assessed for appropriateness for therapeutic hypothermia, be cooled in a timely manner, maintained while hypothermic, rewarmed within a specified time frame, and then assessed for whether hypothermia was successful for the patient through neuroprognostication. Nurses caring for therapeutic hypothermia patients must be knowledgeable and prepared to provide care to the patient and family. This article provides an overview of the complexity of therapeutic hypothermia for patients with return of spontaneous circulation in the form of a case study.
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Crit Care Nurs Clin North Am · Dec 2014
ReviewOverview of extracorporeal membrane oxygenation in cardiogenic shock.
In recent years, the use of extracorporeal membrane oxygenators (ECMO) has proliferated in cardiovascular intensive care units (ICUs) partially due to advances in technology with the development of smaller, more portable machines, and the increasing numbers of patients with end-stage heart failure and cardiogenic shock. The use of ECMO has been found to improve survival rates in this deadly situation. Due to higher volumes of patients requiring ECMO, additional qualified resources for providing ECMO services may be necessary. The purpose of this article was to review cardiogenic shock etiologies, the role of ECMO, and to discuss the transition process of implementing a nurse-run ECMO program.
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Crit Care Nurs Clin North Am · Dec 2014
ReviewIncidence and prevention of delirium in critical care patients.
Delirium in the intensive care unit is prevalent and a topic of high interest. Although it has been studied a great deal, screening, prevention, and management remain difficult. There are many causes of delirium and equally as many approaches to prevention and treatment. Two case studies sharing the challenges and successes of education, prevention, and treatment of delirium are presented in the context of complex adaptive systems.
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Crit Care Nurs Clin North Am · Dec 2014
ReviewImplications and interventions related to obstructive sleep apnea.
Surgical patients with known or unknown obstructive sleep apnea are at increased risk for postoperative complications. By implementing evidence-based practices and a validated screening tool, the postoperative surgical patients at the authors' hospital have a decreased risk of postoperative complications, specifically oversedation. This article discusses the pathophysiology, prevalence, risk factors, care of the postsurgical patient, and use of the validated STOP-Bang questionnaire with obstructive sleep apnea as the focus.
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Crit Care Nurs Clin North Am · Dec 2014
ReviewStroke care using a hub and spoke model with telemedicine.
Stroke is the fourth leading cause of death in the United States. On average, someone has a stroke every 40 seconds. ⋯ Telemedicine has assisted in bridging this gap to provide effective stroke treatment. The purpose of this article is to describe how the implementation of a hub and spoke model using telemedicine has assisted in increasing patient access to neurology expertise and receiving evidence-based treatment of recombinant tissue plasminogen activator, thereby improving patient outcomes.