Critical care nursing clinics of North America
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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.
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Crit Care Nurs Clin North Am · Mar 2008
Stateside care of marines and sailors injured in Iraq at the National Naval Medical Center in Bethesda, Maryland.
This article has been written by four staff members from the Critical Care Department at the National Naval Medical Center in Bethesda, Maryland. They are part of a large and extremely sophisticated medical response team who cares for the injured when they return to the United States. ⋯ It describes the unique and profound emotional responses of the staff members who are instrumental in the recuperation of the service member. It also tells of the joy of recovery from horrific injuries, and the intense dedication of staff members to the military wounded.
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Crit Care Nurs Clin North Am · Dec 2007
ReviewAtrial fibrillation and the postoperative cardiac surgery patient.
Atrial fibrillation (AF) is the most common dysrhythmia that affects adults, with an estimated 2.2 million people diagnosed in the United States and 4.5 million in the European Union. The development of postoperative AF is associated with negative patient outcomes. This article provides critical care nurses with an understanding of the etiology of AF, risk factors associated with the development of it, and current treatment options for this dysrhythmia. In addition to the medical management of AF, an overview of preventive protocols, nursing implications, and patient education is provided.