American journal of critical care : an official publication, American Association of Critical-Care Nurses
-
Comment Letter
Intensivist training programs and standardization of care.
-
In an attempt to transform the health care system in the United States to improve upon the inadequacies and deficiencies of our current model, the Robert Wood Johnson Foundation and the Institute of Medicine created a collaborative partnership to spell out what aspects of our health care system need to be remodeled. They envisioned that "interprofessional collaboration and coordination would be the 'norm,'"(1) because no discipline functions in isolation of others, certainly not in our intensive care units. ⋯ Richard S. Irwin, MD, Master FCCP Editor in Chief, CHEST.
-
Albumin is broadly prescribed for critically ill patients although it does not have a mortality benefit over crystalloids. One common use of albumin is to promote diuresis. Objectives To compare urine output in patients treated with furosemide with and without albumin and to assess other variables possibly associated with enhanced diuresis. ⋯ Addition of albumin to a furosemide infusion did not enhance diuresis obtained with furosemide alone in critically ill patients.
-
BACKGROUND PATIENT: ventilator dyssynchrony is common and may influence patients' outcomes. Detection of such dyssynchronies relies on careful observation of patients and airway flow and pressure measurements. Given the shortage of specialists, critical care nurses could be trained to identify dyssynchronies. ⋯ Specifically trained nurses can reliably detect ineffective inspiratory efforts during expiration.