Nursing in critical care
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Nursing in critical care · Sep 2011
An observational pilot study of CSF diversion in subarachnoid haemorrhage.
A primary focus of hospital treatment following admission for subarachnoid haemorrhage (SAH) is a prevention of cerebral artery vasospasm, which may result in ischaemic stroke. Intraventricular catheter (IVC) insertion to facilitate cerebral spinal fluid (CSF) drainage and intracranial pressure (ICP) monitoring may reduce the incidence or severity of vasospasm, but insufficient evidence exists from which clinicians may determine the best practice of CSF management. ⋯ This study provides a solid foundation for the development of a randomized trial exploring two different methods of ICP monitoring and CSF diversion during the acute phase of care following aneurysm rupture.
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Nursing in critical care · Sep 2011
Risk factors for prolonged stay in cardiac surgery intensive care units.
To identify the factors that might affect the length of stay in the intensive care unit (ICU-LOS) among cardiac surgery patients. ⋯ The correlation between patient perioperative risk and ICU-LOS encourages the early identification of high-risk patients for prolonged hospitalization. Furthermore, the relationship between NWL and ICU-LOS allows the early identification of these patients with the use of an independent nursing tool.
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Delirium as a result of hospitalization in an intensive care unit (ICU) is defined by a mental state different from the patients' normal state and an acute fluctuating course. Both morbidity and mortality are increased in relation to delirium. The incidence of delirium has been reported from 16% to 87% in international studies primarily in elderly patients. ⋯ In this study delirium occurred in 40% of adult ICU patients of all ages.
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To outline the pathophysiological processes involved in neurovascular impairment and compartment syndrome and examine common contributory factors within the development and clinical presentation of neurovascular impairment in critical care patients with musculoskeletal trauma. ⋯ Undertaking an effective neurovascular assessment for patients at risk of neurovascular impairment or acute compartment syndrome (ACS) in the critical care setting can be problematic when patients are unable to communicate with the nurse. The risk of long-term functional impairment or limb loss can be significant in this group of patients, particularly following musculoskeletal trauma. This article reviews the aetiology and pathophysiology of neurovascular impairment in the critical care context and provides guidance for nurses undertaking this important element of nursing assessment with non-verbal, critically unwell patients. Informed practice in neurovascular assessment has the potential to enable early detection and timely management for these patients, which is crucial to optimise patient outcomes.
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Nursing in critical care · Jul 2011
Comparative StudyPain assessment in turning procedures for patients with invasive mechanical ventilation.
The assessment of pain is particularly difficult in critical patients unable to self-report or with cognitive impairment. In such cases, the use of scales which evaluate pain through patient behaviour is important. ⋯ The good measurement qualities of the CPOT scale obtained during a painful procedure recommend its use in intensive care units (ICUs) for adult patients with artificial ventilation.