Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 2004
Randomized Controlled Trial Clinical TrialManagement of the changeover of inotrope infusions in children.
Inotropes are drugs that can assist the critically ill patient's heart to function more effectively by increasing contractility. Inotrope infusions are run continuously and fresh infusions are required on a regular basis. The two methods of changeover commonly used are the quick-change and the double-pump methods. Haemodynamic compromise can occur to some degree with both methods. Evidence regarding the most effective method is limited to individual experience and anecdote. Therefore, the aim of this project was to determine the best method of changing inotropic infusions in children. ⋯ There was no statistically or clinically significant difference detected in changes to MAP. A rescue bolus was required on only one occasion during quick-change over for a reduction in MAP of > or = 20% in the quick-change group. Therefore, a quick-change method can be considered more effective as it reduces the time required for changeover and the risk of tolerance to higher levels of inotrope, while maintaining haemodynamic stability in children after cardiac surgery.
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Intensive Crit Care Nurs · Oct 2004
ReviewIncreasing awareness of tissue donation: in the non-heart beating donor.
Many healthcare professionals (nursing and medical staff) are familiar with asking families to consider organ donation in the brain-stem death patient. In contrast few healthcare professionals raise the subject of tissue donation with the newly bereaved non-heart beating donor (NHBD) families following cardiac death. The failure of healthcare professionals to approach theses families is strongly supported in the literature [Crit. ⋯ A tool of structured reflection [J. Nurse Manager 1 (1993) 9] will be used to highlight the use of reflective practice following a critical incident. On the basis of analysis of current practice consideration will be given for future theoretical arguments in development, research, and education.
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Intensive Crit Care Nurs · Oct 2004
Visits of children to patients being cared for in adult ICUs: policies, guidelines and recommendations.
Little is known about the frequency of children visiting their nearest relatives in adult ICUs or if there are any policies/guidelines or recommendations regarding these. The aims of this multi-centre descriptive study were to survey Swedish ICUs policies/guidelines or recommendations, and examine the reasons given both for and against restricting child visits; if parents/guardians sought advice in connection with such visits, and if any differences in demographic data could be ascertained. Fifty-six Lead Nurse Managers (LNM), representing as many general adult ICUs, participated by answering a questionnaire. ⋯ Seventy percent of the ICUs had no restrictions on visiting hours, but 30% imposed some form of restriction. Twenty LNMs reported that 75% of the parents/guardians of children 0-6 years old asked for advice about child visits. However, those responsible for children >12 years of age seldom asked for any advice at all.
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Intensive Crit Care Nurs · Oct 2004
Memories of intensive care and experiences of survivors of a critical illness: an interview study.
Recovery from a critical illness can be a complex and protracted process. It is known that for some, health-related quality of life (HRQOL) does not return to pre-illness levels for many months, and in some disease processes this may be longer. This study was undertaken as part of a larger project examining the pain and health status of survivors of a critical illness. ⋯ Three common themes were found with our six participants: recollections, responses, and comfort/discomfort. Recovery from their critical illness continued to affect the participants and carers, some profoundly so. Better integration of services and continued support is required for survivors of a critical illness up to and beyond 6 months.