Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Apr 2001
Practice Guideline GuidelineClinical guidelines for the use of the prone position in acute respiratory distress syndrome.
The mortality associated with acute respiratory distress syndrome (ARDS) remains high. It has been suggested that use of the prone position may improve survival. However, approaches to the use of the position are often haphazard. ⋯ This is followed by presentation of the clinical guidelines. Included in these are the criteria and discussion which indicate consideration of the prone position, potential exclusion criteria, pre-turn considerations, the turning technique, monitoring the effectiveness of the prone position, passive movements and limb positioning and, finally, documentation of the problems associated with use of the prone position. The paper concludes with discussion concerning the potential for future research in this area.
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Intensive Crit Care Nurs · Apr 2001
Clinical signs of ICU syndrome/delirium: an observational study.
Some clinical signs of the intensive care unit (ICU) syndrome/delirium are probably known, but there may be additional signs that can be observed during the care of ICU patients. The aim of this study was to investigate and describe the clinical signs of the ICU syndrome in relation to patients' reactions and behaviour following the second day of their stay in an ICU. A total of 31 patients were observed during the weaning process and in the days following extubation. ⋯ Several patients also related unreal experiences only occasionally, while others experienced them during longer periods. The clinical signs did not seem to be separate phenomena but were inter-connected and part of a progression, and, therefore must be seen in the overall context and situation. Longer periods of observation and repeated interaction with patients are necessary in order to be aware of onset and clinical signs of the ICU syndrome.