Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 1998
ReviewIntensive nursing care of patients with a microvascular free flap after maxillofacial surgery.
This article provides an introduction to the care of patients following maxillofacial surgery, many of whom undergo the complexities of microvascular flap surgery and need careful nursing assessment in the postoperative period. A brief introduction to this surgery illustrates some of the potential reasons for admission to the intensive care unit. The nursing care is vital to maintain the survival of the flap, the details of which are discussed along with factors which potentially contribute to flap failure. Other considerations such as haemodynamic stability, postoperative complications, the importance of education and other options for postoperative management also form further points for discussion.
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Intensive Crit Care Nurs · Oct 1998
Historical ArticleThe evolution and nursing history of a general intensive care unit (1962-1983).
In this paper we have reviewed the origin and evolution of Whiston Hospital's General Intensive Care Unit (ICU) from its humble beginnings as an offshoot of a general ward in the early 1960s. The length of service of the senior nursing staff over a period of 21 years was also calculated. ⋯ In addition, we have outlined the development of nurse training in intensive care as well as the role of the nurses in research in the ICU. The question as to whether later college-based training was superior to the previous hospital-based course remained unanswered.
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Intensive Crit Care Nurs · Aug 1998
Randomized Controlled Trial Clinical TrialCan nurses safely assess the need for endotracheal suction in short-term ventilated patients, instead of using routine techniques?
Most literature describes endotracheal suction as a hazardous procedure associated with numerous complications and proposes that it should only be performed as necessary to minimize these complications. Other authors suggest endotracheal suction only after assessment predisposes patients to a number of different complications. This article describes a controlled study to compare and contrast the differences in endotracheal suction outcomes in patients who received ritualized 2 hourly suctioning and those who received it following assessment. ⋯ The results demonstrated a clear increase in nurses' knowledge regarding endotracheal suctioning. The assessed group of patients demonstrated significantly better outcomes and less complications than the controlled group in relation to changes in peak airway pressures, heart rate and mean arterial pressure pre- and post-endotracheal suctioning, and the amount of secretions obtained on suctioning. Although only preliminary, these results do provide support for the view that endotracheal suction only in response to assessment is better practice for short-term ventilated patients.
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Intensive Crit Care Nurs · Aug 1998
Randomized Controlled Trial Comparative Study Clinical TrialA randomized trial comparing Arglaes (a transparent dressing containing silver ions) to Tegaderm (a transparent polyurethane dressing) for dressing peripheral arterial catheters and central vascular catheters.
The purpose of this trial was to prepare for a large randomized trial comparing Arglaes film dressing, a recent innovation containing silver ions, against Tegaderm, a transparent polyurethane dressing. Thirty-one patients admitted to the intensive care unit and requiring the insertion of an arterial line or central venous catheter were recruited into the study. ⋯ The catheter tips were also cultured on removal to establish if there was a difference between the two groups. No statistical differences were found in bacterial growth between the two dressings.
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Intensive Crit Care Nurs · Aug 1998
ReviewIs a murder charge an occupational hazard of intensive care nursing?
When nurses are accused of harming their patients there is an understandable wave of concern. When nurses kill their patients there is disbelief and horror. After all, killing patients is so far from the traditional image of the nurse as to cause distress and disorientation. ⋯ In the UK, of the nurses accused of attempting to murder their patients two came from the same specialism. Two of the three accusations centred on Intensive Care Units (ICU); the case of Amanda Jenkinson (Kenny 1996) and the case of Kath Atkinson, an ICU sister in Newcastle (Porter 1998a). In the most notorious case of nurse homicide in the UK this decade, that of paediatric nurse Beverly Allitt, the profession and society at large were shaken by accusations so serious as to defy belief.