American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial Clinical Trial
Effects of interpleural bupivacaine on pleural chest tube removal pain: a randomized controlled trial.
Moderate to severe pain associated with the removal of pleural chest tubes is poorly controlled with opioids. New methods are needed to manage the pain associated with this procedure. ⋯ These data demonstrate that chest tube removal pain is of moderate to severe intensity and that pleural chest tube injections of bupivacaine were not effective in decreasing chest tube removal pain. However, the decrease in pain associated with the administration of ketorolac warrants future study.
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Psychological management of parents during a child's critical illness is a challenge to intensive care nurses because of the uncertainty that accompanies hospitalization. ⋯ Family relationship are important factors to consider when clinicians estimated the effect on parents of their child's critical illness, particularly when uncertainty over their child's outcome may lead to parental stress that can interfere with coping and child management. (American Journal of Critical Care.)
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Randomized Controlled Trial Clinical Trial
Effect of lateral position on arterial and venous blood gases in postoperative cardiac surgery patients.
Investigators have suggested that lateral position may have clinically significant effects on oxygenation in cardiac surgery patients. Presence of lung disease and type of cardiac surgery may be important considerations. ⋯ The results of this study support those of previous research, which reported lower PaO2 in postoperative coronary artery bypass graft patients in the left lateral position. Mean differences in PaO2 were small, suggesting that the known benefits of lateral positioning in the early postoperative period outweigh the potential risks.
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A range of neuro-cognitive sequelae, from mild intellectual impairments to brain death, have been reported in survivors of aborted sudden cardiac death. ⋯ Our results suggest that half of the long-term survivors of aborted sudden cardiac death are cognitively intact 6 months after resuscitation but that 25% have moderate to severe impairment in memory, which could hamper and/or preclude the resumption of prearrest roles.
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Despite a strong national commitment to excellence in healthcare, the available resources are limited. Cardiac surgery consumes more healthcare resources than any other single treatment. It is imperative that healthcare professionals evaluate the traditional methods used to deliver quality care. ⋯ A decrease in intubation time, respiratory infections, wound infections, laboratory procedures, length of stay, and costs has been demonstrated. In a follow-up patient and family survey, high satisfaction with nursing care, patient and family education, and length of hospitalization has been voiced. Anticipated goals have been exceeded and improvements in standards continue to be made.