Critical care nursing clinics of North America
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Capnography or end-tidal carbon dioxide (Etco2) monitoring has a variety of uses in the pediatric intensive care setting. The ability to continuously measure exhaled carbon dioxide can provide vital information about airway, breathing, and circulation in critically ill pediatric patients. ⋯ This modality allows for noninvasive monitoring and has become the standard of care. This article reviews the basic principles and clinical applications of Etco2 monitoring in the pediatric intensive care unit.
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Crit Care Nurs Clin North Am · Jun 2017
ReviewPutting the Family Back in the Center: A Teach-Back Protocol to Improve Communication During Rounds in a Pediatric Intensive Care Unit.
Patient- and family-centered care is endorsed by leading health care organizations. To incorporate the family in interdisciplinary rounds in the pediatric intensive care unit, it is necessary to prepare the family to be an integral member of the child's health care team. When the family is part of the health care team, interdisciplinary rounds ensure that the family understands the process of interdisciplinary rounds and that it is an integral part of the discussion. An evidence-based protocol to provide understanding and support to families related to interdisciplinary rounds has significant impact on satisfaction, trust, and patient outcomes.
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Crit Care Nurs Clin North Am · Dec 2016
ReviewSpecial Considerations in the Nursing Care of Mechanically Ventilated Children.
Mechanical ventilation is often required to support the recovery of critically ill children. Critical care nurses must understand the unique needs of the children and design supportive care that is sensitive to their changing physiology, developmental stage, and socioemotional needs. ⋯ It addresses invasive and noninvasive ventilation and the needs of long-term ventilated children and family in critical care. Supportive nursing care that is aligned with the unique needs of the critically ill child is paramount to ensuring best outcomes for these vulnerable patients.
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Crit Care Nurs Clin North Am · Dec 2016
ReviewBest Practices for Managing Pain, Sedation, and Delirium in the Mechanically Ventilated Patient.
Nursing management of pain, agitation, and delirium in mechanically ventilated patients is a challenge in critical care. Oversedation can lead to delayed extubation, prolonged ventilator days, unnecessary neurologic testing, and complications such as weakness and delirium. ⋯ Acquiring an optimal level of sedation requires the bedside nurse to be more vigilant than ever with patient assessment and medication titration. This article provides a historical perspective of the management of pain, agitation, and delirium, and disseminates information contained in revised Society for Critical Care Medicine Clinical Practice Guidelines (January 2013) to promote their implementation in day-to-day nursing care.
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Crit Care Nurs Clin North Am · Dec 2016
ReviewNursing Strategies for Effective Weaning of the Critically Ill Mechanically Ventilated Patient.
The risks imposed by mechanical ventilation can be mitigated by nurses' use of strategies that promote early but appropriate reduction of ventilatory support and timely extubation. Weaning from mechanical ventilation is confounded by the multiple impacts of critical illness on the body's systems. Effective weaning strategies that combine several interventions that optimize weaning readiness and assess readiness to wean, and use a weaning protocol in association with spontaneous breathing trials, are likely to reduce the requirement for mechanical ventilatory support in a timely manner. Weaning strategies should be reviewed and updated regularly to ensure congruence with the best available evidence.