Critical care nursing clinics of North America
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A plethora of information exists in the literature regarding emergencies and disasters. Nevertheless, significant gaps in the science related to nurses working during disasters are revealed. Few studies have addressed the perspective of nurses and their intent to respond to future disasters. ⋯ Nevertheless, disasters continue to adversely impact communities and hospitals at all levels causing injuries, death, and destruction of infrastructure. To reduce the impact of disasters, continued research is needed to inform and strengthen future disaster policies. Knowledge gained from future research has great potential to inform nursing education, research, and practice, as well as health policy related to the care of individuals and responders before, during, and after disasters.
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Crit Care Nurs Clin North Am · Dec 2010
Keeping PEDIATRICS in pediatric disaster management: Before, during, and in the aftermath of complex emergencies.
From 1900 there have been more than 9800 natural disasters affecting more than 67 million children worldwide. Because of unique physical, developmental, and psychosocial characteristics of children, caring for them during complex emergencies is different to caring for adults. However, planning for these unique physical, developmental, and psychosocial needs has not been well addressed when planning for complex emergencies. Therefore, the purpose of this article is to review those characteristics of children that place them at higher disaster risk, and discuss the preparations necessary to meet their needs before, during, and in the aftermath of complex emergencies.
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Crit Care Nurs Clin North Am · Sep 2010
ReviewDrug dosing considerations for the critically ill patient with liver disease.
Hepatic dysfunction in the critically ill patient presents a unique challenge to clinicians when designing pharmacotherapeutic treatment plans. Overall, the literature regarding drug dosing in critically ill patients with hepatic dysfunction is incomplete and current tools available to bedside clinicians have limitations. ⋯ This information can be applied clinically and careful monitoring plans can be implemented to assess a drug for efficacy and safety. This article reviews the pharmacokinetic changes that can occur in hepatic failure, identifies practical ways to quantify the severity of dysfunction, and discusses general drug dosing strategies in this patient population.
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Crit Care Nurs Clin North Am · Sep 2010
ReviewInfectious diseases in end-stage liver disease patients.
Patients with chronic liver diseases sustain impairment to immune systems, which worsens over time. These defects in their host defense lead to risks of bacterial infections and increased morbidity. ⋯ There should be a low threshold for obtaining diagnostic cultures and peritoneal fluid samples and discussing possible causes with an infectious diseases consultant or a microbiology laboratory. These maneuvers will maximize therapy in patients at high risk for death due to infectious disease.