Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Jun 2003
Preparing to respond: Joint Trauma Training Center and USAF Nursing Warskills Simulation Laboratory.
Injuries related to the events of September 11, 2001, and continuing military actions associated with Operation Enduring Freedom underscore the accurate focus of the Joint Trauma Training Center and the Warskills Simulation Laboratory. These two programs ensure that nurses are prepared to respond to diverse medical situations worldwide. Outcome measures from both initiatives attest to the effectiveness of an integrated program that facilitates critical thinking skills and clinical judgment to increase the nurses' ability to provide trauma care to severely injured military personnel.
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Crit Care Nurs Clin North Am · Jun 2003
Blue water nursing: the role of Navy nurses on board US Navy combatant ships.
The independent and autonomous nature of blue water nursing makes its practice exceptionally demanding, exciting, and rewarding for Navy nurses assigned to US Navy combatant ships. Whether serving on board an aircraft carrier or an amphibious assault ship, the lone critical care nurse is responsible for a diverse mix of nursing care ranging from community health to critical care. Delivering this care in an austere shipboard environment at sea, often in isolated locations without regular available support from shore-based medical facilities, defines the blue water aspect of this nursing practice. ⋯ Because the nurse cannot do it all alone, taking the lead on providing training and clinical guidance to the Corpsmen is a key responsibility of the shipboard nurse. In this assignment, the critical care nurse also has a unique opportunity to make an impact the health and welfare of the ship's entire crew through wellness and prevention programs. Considering the personal and professional challenges and rewards of blue water nursing, most Navy nurses describe their tour of duty on board a combatant ship as the best assignment of their Navy career.
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With the understanding that parents are the vital link to the child, nurses can develop plans of care based on research. Family functioning must be assessed as families attempt to deal with the stress involved in the hospitalization of a child with sepsis. ⋯ The stress of hospitalization may have long-term effects on children and families. Future research is needed to develop additional interventions that can be applied while the child is hospitalized and after discharge to aid the family in coping with stress.
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Severe sepsis and septic shock are among the most complex and challenging conditions treated by critical care practitioners. Although the pathophysiology of severe sepsis and septic shock is not fully understood, bacteria and immune responses are known to trigger the release of cytokines. These cytokines initiate a cascade of events that lead to illness behaviors such as fever, anorexia, and sleepiness, as well as a host of physiologic events such as activation of the coagulation cascade, vasodilation, hypotension, and increased vessel permeability. As research advances the understanding of severe sepsis and septic shock, practitioners must become aware of the cellular basis of events so that treatments can be implemented knowledgeably and evaluated.
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Crit Care Nurs Clin North Am · Mar 2003
ReviewThe role of the critical care nurse in the assessment and management of the patient with severe sepsis.
Sepsis with acute organ dysfunction is common, frequently fatal, and expensive. The critical care nurse is involved in the continuous bedside care of the critically ill patient; consequently, he or she has the opportunity to prevent sepsis through infection control practices and general nursing care, to identify patients at risk for the disease, to monitor these patients for the clinical signs of sepsis, and to detect developing organ dysfunction as a manifestation of severe sepsis. ⋯ Drotrecogin alfa (activated) is a promising new therapy in the treatment of severe sepsis. Nurses caring for patients with this disease need to understand the issues related to the administration of drotrecogin alfa (activated) and the monitoring of patients receiving this drug to promote optimal and appropriate use of this innovative therapy.