American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial Comparative Study
Transparent film dressing vs pressure dressing after percutaneous transluminal coronary angiography.
Pressure dressings have been used as the standard following sheath removal after percutaneous transluminal angioplasty in many institutions. Patients complain about discomfort while the dressing is in place, pain when the dressing is removed after discharge, and skin complications afterward. Many patients have experienced skin irritation where tape has been applied. Nurses have also described difficulty assessing the sheath insertion site in the groin when a pressure dressing is in place. ⋯ As a result of this study, a practice change was made hospital-wide: rather than a standard opaque pressure dressing, a transparent film dressing is used for all patients after removal of a femoral sheath.
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The effect of the depth of sedation on the function of the autonomic nervous system is not well known. ⋯ Deep sedation may be associated with depression of parasympathetic function in patients receiving mechanical ventilation. Use of benzodiazepines most likely contributed to this finding.
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Comparative Study
Differences in glucose values obtained from point-of-care glucose meters and laboratory analysis in critically ill patients.
Blood for glucose analysis is often obtained interchangeably from indwelling catheters and fingersticks. ⋯ Use of a commonly used point-of-care device when precise glucose values are needed may lead to faulty treatment decisions.
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Given their clinical, research, and administrative purposes, scores on the Acute Physiology and Chronic Health Evaluation (APACHE) II should be reliable, whether calculated by health care personnel or a clinical information system. ⋯ After completion of a quality improvement intervention, health care personnel and a computerized clinical information system calculated sufficiently reliable APACHE II scores for clinical, research, and administrative purposes.