American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Nurses working in intensive care units may lack knowledge and skills in end-of-life care, find caring for dying patients and the patients' families stressful, and lack support to provide this care. ⋯ Continued practice development is needed in end-of-life care issues.
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Casts may be associated with, and mask, serious life-threatening complications, including infection, compartment syndrome, and deep vein thrombosis with or without pulmonary embolism. A 43-year-old woman had necrotizing fasciitis associated with a closed-reduction casting of a tibial fracture. Her treatment highlights the importance of removing a cast and assessing the skin and tissue underneath for signs of infection in patients with suspected infection. Thorough assessment, early diagnosis, and early intervention in necrotizing fasciitis and sepsis are important to improve patients' outcomes.
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Multicenter Study
Medical end-of-life decisions: experiences and attitudes of Belgian pediatric intensive care nurses.
To investigate Belgian pediatric intensive care nurses' involvement in and attitudes toward medical end-of-life decisions with a possible or certain life-shortening effect. ⋯ Belgian pediatric intensive care nurses are often involved in carrying out medical end-of-life decisions, including administration of life-ending drugs, whereas their participation in decision making is more limited. Most think that the current euthanasia law should be extended to minors so that administering life-ending drugs would be possible for terminally ill children in specific circumstances.
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Endotracheal tube cuff pressure must be maintained within a narrow therapeutic range to prevent complications. Cuff pressure is measured and adjusted intermittently. ⋯ Continuous monitoring of cuff pressure is feasible, accurate, and safe. Cuff pressures vary widely among patients.