Enfermería intensiva
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The aim of this study was to demonstrate the usefulness of the intraosseal route in providing emergency vascular access, especially in children, when vascular access through peripheral or central routes is difficult or impossible. A literature review revealed that the intraosseal route provides rapid, easy and effective access to the vascular system, especially in children under the age of 6 years. This route is indicated when, in emergencies, peripheral or central cannulation is too slow and the child's life is at risk. ⋯ In addition to providing an alternative route for the infusion of drugs and other substances into the bloodstream, the intraosseal route also provides access to the vascular system when samples for laboratory investigations are required. In conclusion, the intraosseal route provides rapid, safe and easy access to the vascular system. Complications are infrequent and there are few contraindications.
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Enfermería intensiva · Jan 2001
Review[Weaning from mechanical ventilation. The aim of nursing research].
Management of patients difficult to wean from the ventilator is a practical challenge in which professional nurses are deeply involved. The clinical research applied over the last years has tried to describe the characteristics of weaning phenomenon and the associated factors, to find predictive outcomes to guide clinical decisions, to search new strategies to conduct the protocols and to identify the most effective modes of weaning. In this paper a critical review of the current knowledge from a nursing perspective is done. The weaning conceptual model proposed by the American Association of Critical Care Nurses (AACN) group has been used as a theoretical framework.
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Enfermería intensiva · Oct 2000
Comparative Study[Sample taking through central venous catheter for the control of partial thromboplastin time in patients with heparin sodium perfusion].
The need to systematically monitor activated partial thromboplastin time (APTT) in patients undergoing continuous perfusion of heparin sodium (non-fractionated) in order to maintain therapeutic levels of anticoagulation leads to two questions: 1. can blood be withdrawn from the catheter through which the heparin solution is being perfused without altering APTT values? and 2. how much blood should be discarded so that APTT values remain unchanged? To obtain APTT values in these patients, two samples were extracted simultaneously: one through the central venous catheter through which the heparin was being perfused, after previously discarding 10 or 20 ml of blood according to the group to which the patient was assigned and the other through direct venous puncture or through the peripheral catheter inserted in the arm not being used for heparin perfusion. The values obtained by both methods were analyzed for statistical significance. ⋯ These differences were lower when 20 ml were discarded than when 10 ml were discarded. In conclusion, APPT monitoring should be performed whether the sample is obtained through direct venous puncture or through a peripheral catheter inserted in the arm not being used for heparin perfusion.
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Enfermería intensiva · Oct 2000
[Description of the "new" intensive care unit of the Valladolid Río Hortega Hospital].
The unit described herein forms part of the Rio Hortega Hospital in Valladolid (Spain) and is situated on the third floor. The building houses several medical and surgical specialities and has been renovated several times; the latest renovations have involved technical and structural renovation of the Intensive Care Unit. The new intensive care unit was inaugurated in February 1998 due to new technical and medical requirements. ⋯ The hospital has three catholic priests who periodically visit the patients. We also try to help when the patients profess other religious faith. The type of patients who are cared for in the unit as well as their distribution according to condition, severity, death, etc, is shown in figures: the data correspond to the period from January 1 1998 to August 1 1999.
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Enfermería intensiva · Jul 2000
[Postural technique in prone position: hemodynamic and respiratory parameters and complications].
Therapeutic strategies used in the treatment of adult respiratory distress syndrome (ARDS) recommend placing the patient in prone position as an effective method for optimizing ventilation-perfusion parameters. We evaluated the therapeutic effect of postural treatment in prone position with the following goals: Comparison of hemodynamic and respiratory parameters before and after placing the patient in prone position, while in prone position, and before and after postural treatment. Complications associated with turning and time in prone position. ⋯ Comparisons before and after postural treatment disclosed a clinically significant difference but no change in pH. Following the protocol for placing the patient in prone position, no complications were associated with the turning procedure (accidental loss of TOT, tracheostomy, SNG, urinary catheter, vascular catheters, chest tubes, and drainage tubes). While patients were in prone position, stage II and III UPP, palpebral and/or conjunctival edema, and intolerance of enteral feeding occurred, but our results do not indicate that these complications appeared solely as a result of prone position.