American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Syncope may be a manifestation of many diseases. The etiology is often difficult to determine. Much effort, time, and expense have been required to determine a diagnosis. ⋯ The Reveal Plus insertable loop recorder has auto activation that allows automatic capture and recording of arrhythmic events. Patient activation is an option. The recorder lasts 12 to 14 months and has proven to be a valuable and reliable cost-effective asset in our quest to evaluate syncope.
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Hypothermia is a serious immediate consequence of traumatic injury in children. Although numerous studies have addressed the treatment of hypothermia in adults after trauma or surgery, few have examined this issue in injured children. ⋯ Caution should be used when extrapolating published data on the treatment of hypothermia in injured adults to injured children. Ongoing clinical trials should evaluate in children with trauma those warming methods that have been used successfully in surgical patients.
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Comparative Study
Differences between blacks and whites with coronary heart disease in initial symptoms and in delay in seeking care.
Mortality rates for coronary heart disease are higher in blacks than in whites. ⋯ Blacks were more likely than whites to have shortness of breath and left-sided chest pain as the presenting symptoms of coronary heart disease. Differences in delay in seeking treatment were not significant, although blacks tended to delay longer than did whites. The relatively small number of blacks may account for the lack of observed racial differences in both initial symptoms and in delay in seeking treatment.
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Comparative Study
Temperature measurement in critically ill adults: a comparison of tympanic and oral methods.
Despite increasing use of tympanic thermometers in critically ill patients who do not have a pulmonary artery catheter in place, variations in measurements obtained with the thermometers are still a problem. ⋯ Oral thermometers provide less variable measurements than do tympanic thermometers. Use of oral thermometry is recommended as the best practice method for temperature evaluation in critical care patients when measurement of core temperature via a pulmonary artery catheter is not possible.
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Aortic reconstruction surgery for aneurysmal and occlusive disease is associated with significant morbidity and mortality. ⋯ The variables associated with poor outcomes can be used to design a best-practice initiative for patients undergoing elective aortic reconstruction.