Critical care nursing clinics of North America
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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.
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The quality of maternal care in the United States is receiving increased attention due to rising rates of severe maternal morbidity and maternal mortality when compared with other developed countries. Many of these events are considered preventable. ⋯ Maternal levels of care described by the American Congress of Obstetricians and Gynecologists requires increased focus so that women are in the appropriate facility to receive care. Perinatal care management, integrated behavioral health, and preconception care should be considered a preferred methodology to achieve optimal maternal outcomes.
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Crit Care Nurs Clin North Am · Sep 2018
ReviewHit or Miss? A Review of Early-Onset Sepsis in the Neonate.
For the bedside nurse identifying at-risk neonates for development of early-onset sepsis is a challenge. The ambiguity of clinical presentation can easily be overlooked, resulting in delayed treatment of this vulnerable population. Adding to this dilemma is inconsistent implementation of screening criteria used by health providers to identify at-risk neonates, resulting in lost opportunities of early identification and treatment. This article discusses the current approach to and the nurse's role in early-onset sepsis.
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Crit Care Nurs Clin North Am · Sep 2018
ReviewSummary of the 2016 International Surviving Sepsis Campaign: A Clinician's Guide.
The Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 provides updated recommendations, rationales, and evidence tables for best care of patients with sepsis. "Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock (sepsis-3) is a subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality than with sepsis alone." Sepsis and septic shock are major health care problems, affecting millions of people around the world each year. Early identification and management of sepsis and septic shock in the initial hours after sepsis develops, improves outcomes.
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Crit Care Nurs Clin North Am · Sep 2018
ReviewEmerging Adjunctive Approach for the Treatment of Sepsis: Vitamin C and Thiamine.
Evidence is emerging that parenteral administration of high-dose vitamin C and thiamine may be a beneficial adjuvant therapy of severe sepsis and septic shock. Despite modern practices in critical care medicine, sepsis and severe sepsis remain a leading cause of morbidity and mortality in the critical care unit.