Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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The last decade has witnessed phenomenal developments available for the critically ill, especially for the patient in shock. These advances have implications for all members of the health care team as new roles and functions are constantly emerging. As the therapies practised today continue to expand, this demands a greater level of expertise for all those involved in critical care. ⋯ From a theoretical knowledge base on shock with a review of patient goals of therapy, the discussion is developed with reference to the clinical application of the haemodynamic profile. The parameters, their calculation and meaning for patient treatment is examined using clinical exemplars. The paper concludes by re-affirming the themes drawn on throughout the paper of holistic care, independent and interdependent team relationships and accountable professional practice.
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This paper is based on consideration of the ethical issues surrounding organ donation. This emotive subject has far-reaching implications concerning both donation and transplantation but the purpose in this paper is to deal specifically with issues related to cadaveric organ donation and how they concern nurses in an intensive care unit (ICU). A brief, general description of both ethics and organ donation is followed by a discussion of the issues surrounding the donor himself, including the diagnosis of brainstem death, the donor's family, and the nursing and medical implications. Legal, social and economic factors are considered with the aim of highlighting ethical areas but not necessarily providing answers to the questions raised.
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Intensive Crit Care Nurs · Sep 1992
The most important needs of parents of critically ill children: parents' perceptions.
Research studies have identified the needs of relatives when they have had an adult family member in the intensive care unit. However little similar work has been done within the paediatric setting. Therefore the aim of this study was to examine what parents considered to be their most important needs, when they have a child ill in the intensive care environment (PICU). ⋯ The parents were required to indicate how important each need was to them during the time of the child's stay in the PICU. Results obtained indicate that parents have a strong need for information and relief of anxieties that they may have about their child's condition. A conclusion reached in this study is that if the critical care staff can go some way to assess and meet the needs of parents of critically ill children, then these parents may be more able to become effective partners in care, which may have therapeutic effects upon the child's health recovery.
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Intensive Crit Care Nurs · Jun 1992
Aspects of neurosurgical assessment using the Glasgow Coma Scale.
The Glasgow Coma Scale (GCS) has become a cornerstone of the neurological/surgical assessment of patients used by both nursing and medical staff. Since its development in the 1970s it has been used in a variety of clinical situations to monitor changes in a number of key neurological functions, including level of consciousness, pupil reaction and limb movement. During this time, however, there have been suggestions that there are problems with some of the measurement principles underlying its use, which in part has stimulated the development of other neuro-assessment tools. ⋯ The criterion for judging the accuracy of subject's assessments was established by a panel of experts. As expected, RGNs had the highest proportion of correct assessments and students the least. Subjects were identified as having difficulty in determining the relative amounts of weakness that a patient exhibited, and in correctly distinguishing between flexion and extension.
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Intensive Crit Care Nurs · Jun 1992
Continuous monitoring of mixed venous saturation (SvO2): an adjunct to nursing assessment?
Technological advances in oximetry have enabled the development of a pulmonary artery catheter which allows the continuous monitoring of a patient's mixed venous oxygen saturation (SvO2), which is recognised as a valuable indication of cardiac output and the balance between oxygen supply and demand (delivery and consumption). This paper briefly explains the rationale for monitoring SvO2 and highlights possible areas where the data it provides could influence the assessment and implementation of nursing interventions undertaken within intensive care units, and enable those decisions to be made more safely.