American journal of critical care : an official publication, American Association of Critical-Care Nurses
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No standard protocol exists for the treatment of acute respiratory distress syndrome induced by inhalation of smoke from a smoke bomb. In this case, a 23-year-old man was exposed to smoke from a smoke grenade for approximately 10 to 15 minutes without protective breathing apparatus. Acute respiratory distress syndrome developed subsequently, complicated by bilateral pneumothorax and pneumomediastinum 48 hours after inhalation. ⋯ On day 16 of hospitalization, the patient experienced progressive deterioration of arterial oxygenation despite the intensive treatment. The initial treatment regimen (ie, corticosteroids and extracorporeal life support) was resumed, and the patient's arterial oxygenation improved. The patient survived.
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A survey of nurses' beliefs about the medical emergency team system in a canadian tertiary hospital.
Nurses are the primary activators of the medical emergency team (MET). Although the MET system can empower nurses to seek help in managing acutely ill patients, few data on nurses' beliefs about the system are available. ⋯ Nurses value the MET system. Nurses believe that the MET can help them care for acutely ill patients and improve outcomes. However, barriers to MET activation exist, including a fear of criticism and an adherence to a more traditional model of first contacting the responsible physician before activating the MET.
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Few investigators have evaluated pain assessment tools in the critical care setting. ⋯ Although similar in content to other behavioral pain scales, the FLACC can be used across populations of patients and settings, and the scores are comparable to those of the commonly used 0-to-10 number rating scale.
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Reliance on physiological monitors to continuously "watch" patients and to alert the nurse when a serious rhythm problem occurs is standard practice on monitored units. Alarms are intended to alert clinicians to deviations from a predetermined "normal" status. However, alarm fatigue may occur when the sheer number of monitor alarms overwhelms clinicians, possibly leading to alarms being disabled, silenced, or ignored. ⋯ Although alarms are important and sometimes life-saving, they can compromise patients' safety if ignored. This unit-based quality improvement initiative was beneficial as a starting point for revamping alarm management throughout the institution.