Critical care nursing clinics of North America
-
Patients who survive to hospital admission after bums with inhalation injury face a difficult and potentially prolonged course of treatment in the burn center. Continuing survival and especially functional outcome hinges on the patient's receiving comprehensive, well-coordinated care from an interdisciplinary team of skilled health care providers. ⋯ Those who do may face prolonged and painful therapies on the way to recovery. The expert nurse managing and caring for this unfortunate population faces tremendous clinical challenges but also has the opportunity and satisfaction of helping each patient achieve the best possible outcome.
-
Ideally, in a burn-traumatized patient, nonviable skin and tissues should be excised early in the course of treatment and replaced with a graftable material that mimics the properties of normal skin in function,texture, sensation, and appearance. The difficulty in identifying indeterminate-depth dermal injuries requires further studies to establish the line between extending injury and delaying the progressive excision of nonviable tissue. ⋯ Therefore, greater emphasis must be placed on improving the overall treatment process and the quality of the end result for these patients. Surgically directed and laboratory-based investigations into the cellular components of wound repair and the development of alternative methods of final wound closure are continuing to evolve, and bum specialists are,optimistic that new alternatives will become available for their patients.
-
Crit Care Nurs Clin North Am · Sep 2003
Use of complementary and alternative therapies to promote sleep in critically ill patients.
The efficacy of complementary and alternative therapies for sleep promotion in critically ill patients is largely unexamined. We found only seven studies (three on environmental interventions and one each on massage, music therapy, therapeutic touch, and, melatonin) that examined the effect of complementary and alternative therapies. A number of studies, however, have shown that massage, music therapy. and therapeutic touch promote relaxation and comfort in critically ill patients, which likely leads to improved sleep. ⋯ In summary, we recommend that ICU nurses implement music therapy, environmental interventions, therapeutic touch, and relaxing massage to promote sleep in critically ill patients. These interventions are safe and may improve patient sleep, although randomized controlled trials are needed to test their efficacy. Aromatherapy and alternative sedatives require further investigation to determine their safety and efficacy.
-
Crit Care Nurs Clin North Am · Jun 2003
ReviewCare of the critically ill patient in a military unique environment: a program of research.
The goal of the Air Force Nursing Research Program at WHMC is to conduct research on topics unique to Air Force and military nursing. The nine stressors of flight and the military environment of care have been used as a conceptual model to guide the development of research studies. The studies conducted to date describe how the environment affects practice and when the environment directly affects the patient. ⋯ In addition, the suction pressure will need to be increased to account for the effects of altitude without exceeding the pressure limits on the transport ventilator and causing catastrophic ventilator failure. Because there is not enough room on the litter for the chest tube drainage tubing to lay straight, it will be coiled and should dependent loops develop, they should be drained every 15 minutes. This is Air Force nursing research in practice.
-
Crit Care Nurs Clin North Am · Jun 2003
Review Case ReportsManaging critical care casualties on the Navy's hospital ships.
In this article, a history of the hospital ships was recounted. Recent missions were described in terms of the ship and crew's capability based on education and mock training exercises. Patient flow was described and a case scenario was presented to illustrate surgically intensive management of critical care casualties. Finally, thoughts on the future of hospital ships were discussed.