American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Case Reports
Dexmedetomidine to treat lisdexamfetamine overdose and serotonin toxidrome in a 6-year-old girl.
A 6-year-old girl displayed symptoms of serotonin syndrome after accidental ingestion of Vyvanse (lisdexamfetamine dimesylate). Dexmedetomidine was administered because of persistent neuromuscular hyperactivity and severe agitation despite initial therapy with benzodiazepines. Some children show a paradoxical reaction to benzodiazepines, and dexmedetomidine has a possible role in the treatment of serotonin syndrome.
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Readmission within 48 hours is a leading performance indicator of the quality of care in an intensive care unit. ⋯ The adverse effect of readmission to the intensive care unit on survival appears to be long-lasting, and predictors of readmission are scarce.
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Family members of patients in intensive care are at increased risk for psychological symptoms. ⋯ Family members' symptoms of posttraumatic stress disorder, anxiety, and depression significantly decreased 3 months after the intensive care experience and did not differ according to the patients' final disposition. However, many family members still had significant risk for posttraumatic stress disorder and borderline anxiety and depression at 3 months.
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After removal of temporary pacemaker wires, nurses measure vital signs frequently to assess for cardiac tamponade; however, evidence for this procedure is limited. ⋯ Tamponade related to pacer wire removal was rare and not consistently associated with changes in vital signs. Dyspnea, bleeding, and other factors may indicate early onset of cardiac tamponade after removal of temporary pacer wires.
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The Synergy Model describes nurses' work on the basis of the individual needs of patients and their families. ⋯ The Synergy Model shows promise as a conceptual framework for a nursing productivity system. Using a model that centers nursing work on patients' needs may better capture what nurses do and enhance our capacity to quantify nursing resource allocation.