American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Clinical Trial Controlled Clinical Trial
Obtaining blood samples for coagulation studies from a normal saline lock.
To determine the amount of blood that should be discarded from a peripheral normal saline lock, a capped-off intravenous port, before a blood sample is obtained for determination of activated partial thromboplastin time from patients being treated with heparin. ⋯ Nurses can obtain accurate measurements of activated partial thromboplastin time with blood samples obtained from normal saline locks by first discarding a volume of blood equal to 2 times the dead space of the catheter and extension set. Obtaining blood samples in this manner reduces patients' discomfort due to repeated venipuncture and diminishes blood loss.
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Critically ill patients are at high risk for pressure ulcers. ⋯ Patients in intensive care units have an increased risk for pressure ulcers. Although waiting until 12 hours after a patient's admission to the intensive care unit to obtain the initial Braden rating may be reasonable (with the second rating obtained 36 hours after admission), additional research is needed before this practice can be recommended.
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Clinical Trial Controlled Clinical Trial
Instillation of normal saline during endotracheal suctioning: effects on mixed venous oxygen saturation.
Instillation of normal saline before endotracheal suctioning is thought to facilitate removal of secretions and ultimately to improve the patient's oxygenation status. To date, no studies have used an in vivo measure of oxygenation such as mixed venous oxygen saturation to characterize the effects of instillation of normal saline. ⋯ Instillation of normal saline before endotracheal suctioning has an adverse effect on oxygenation as indicated by mixed venous oxygen saturation. This finding contradicts the assumption that instillation of normal saline improves oxygenation status.
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Commotio cordis due to blunt trauma to the precordium is a rare cause of death in young athletes, occurring less frequently than all of the other athletics-related deaths. Several measures, such as the use of safety baseballs and the use of chest protectors, can help protect young athletes from commotio cordis. ⋯ However, the personal, physiological, and cardiovascular benefits of athletics far outweigh the risks. Therefore, the message to parents is to allow their children to participate in athletics because the benefits far outweigh the risks.
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Comparative Study
Measurement of dyspnea in patients treated with mechanical ventilation.
Dyspnea, or difficult breathing, is common in patients receiving mechanical ventilation; however, dyspnea is not routinely or systematically measured. ⋯ The scales showed acceptable reliability and validity, and they will be useful in quantifying dyspnea experienced by patients receiving mechanical ventilation. Further work is needed to evaluate the extent and the severity of dyspnea in such patients in order to evaluate the effectiveness of interventions.