Enfermería intensiva
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Toxic Epidermal Necrolysis (TEN) is a severe skin disorder characterised by separation of the dermal-epidermal junction, as it is observed in second degree superficial burns, and it may also involve any mucosal surface area (otic, buccal, conjunctival, respiratory, genital). This condition is generally induced by the ingestion of drugs, particularly certain antibiotics, nonsteroidal antiinflammatory drugs, and antiepileptic drugs. Mortality has decreased over the last decades, from 80% to about 25% in recent series. ⋯ The main nursing diagnosis include abnormalities in the skin and mucose membranes integrity, risk of infection, loss of blood volume, risk of hypothermia, acute pain, upper airway insufficiency and anxiety. We here review the nursing care of patients with TEN. We emphasize the daily skin and mucose membranes care, and the prevention of conjunctival sinequiae, including daily conjunctival cleaning and debridement of necrotic tissue and fibrin debris using a handle needle.
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Enfermería intensiva · Jul 1999
Randomized Controlled Trial Comparative Study Clinical Trial[Endotracheal aspiration: respirator vs. manual resuscitation as method for hyperoxygenation and hyperinflation].
Endotracheal aspiration protocols (EAT) include hyperoxygenation and hyperinflation to minimize the negative effects of the technique. No conclusive studies have determined the most effective hyperoxygenation and hyperinflation method. This study had two aims: to compare the effects on patient oxygenation and hemodynamics during endotracheal aspiration of secretions using, respectively, a respirator or manual resuscitator as the hyperoxygenation and hyperinflation method. ⋯ Analysis of the effectiveness of the manual resuscitator (the second aim) under the conditions established yielded a mean FIO2 of 0.86 and a mean tidal volume of 153% in relation to baseline tidal volume. Both methods of hyperoxygenation and hyperinflation prevent hypoxia and maintain hemodynamic stability in patients without producing lung damage. The effectiveness of the manual resuscitator for administering high oxygen concentration and large volumes was confirmed.
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Enfermería intensiva · Jul 1999
[Study of the work climate in four critical care units in a hospital].
A study was made of the work climate, which was understood to be the overall group of factors that influence nursing professionals in critical-care units. A descriptive study was made by carrying out an anonymous survey among the staff of four adult critical-care units: intensive care unit, coronary unit, reanimation unit, and cardiac postoperative care unit. The survey included seven factors: occupational satisfaction, occupational stress, occupational pressures, work relations, professional skills, professional training, and sociodemographic variables. ⋯ Unit ergonomics had a negative effect on work activities. Staff felt a lack of information in spite of good relations with superiors and other team members. They felt the need for more social and professional recognition, as well as better economic remuneration, but they expected specialization to palliate these needs to some degree.
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A study was made of the professional profile of nurses working in the intensive care or coronary units of the hospitals of the Community of Castilla-La Mancha, Spain. The study was based on a questionnaire completed by a significant sample of nurses working in these units. ⋯ Ideas and questions about the future of nursing professionals in special intensive care and emergency units are discussed. The development of professional certification for special care is considered, which undoubtedly would contribute to meeting the demands of these professionals.
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Enfermería intensiva · Jan 1999
Comparative Study[Are all sedation scales equally useful for nursing assessment?].
The usefulness of three clinical scales for monitoring sedation in intensive care units was compared. The Ramsay scale, Cook modification of the Glasgow scale, and combined Ramsay-Cook scale were evaluated. Thirty-five patients with continuous intravenous sedation were monitored using all three clinical scales. ⋯ The three scales were considered valid and reproductible, with "good" agreement for the Ramsay scale and "very good" agreement for the Cook modified coma scale and the combined Ramsay-Cook scale. In conclusion, since the Cook modified Glasgow scale was the most reproducible, it is preferred for use in research and daily practice. The Ramsay scale is more subjective, but may be useful for daily nursing activities.