American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Despite years of reducing tobacco use, few studies describe to what extent evidence-based tobacco-cessation interventions are a standard of acute and critical care nursing practice using the US Public Health Service 5 A's framework: ask, advise, assess, assist, and arrange. ⋯ Opportunities abound to create strategies leveraging attributes of nursing and organizational excellence to promote evidence-based approaches to improve health outcomes in acutely and critically ill tobacco-dependent populations.
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Review Case Reports
The Evolving Paradigm of Individualized Postresuscitation Care After Cardiac Arrest.
The postresuscitation period after a cardiac arrest is characterized by a wide range of physiological derangements. Variations between patients include preexisting medical problems, the underlying cause of the cardiac arrest, presence or absence of hemodynamic and circulatory instability, severity of the ischemia-reperfusion injury, and resuscitation-related injuries such as pulmonary aspiration and rib or sternal fractures. Although protocols can be applied to many elements of postresuscitation care, the widely disparate clinical condition of cardiac arrest survivors requires an individualized approach that stratifies patients according to their clinical profile and targets specific treatments to patients most likely to benefit. This article describes such an individualized approach, provides a practical framework for evaluation and triage at the bedside, and reviews concerns specific to all members of the interprofessional postresuscitation care team.