Nursing in critical care
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This case report outlines the treatment and management of a patient who developed ARDS. The causes of ARDS and disordered physiology are discussed briefly. Prone positioning is identified as an important component of management.
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Nursing in critical care · May 1997
ReviewThe needs of parents with a child on an adult intensive therapy unit.
This review examines, by means of a literature search, the needs of parents who have a critically ill child on adult intensive therapy units. These needs are compared with the needs of relatives of adult patients in ITUs. Whether nurses trained in adult nursing have the necessary skills, knowledge and attitudes to care for the parents is also discussed. Recommendations for ensuring care of the parent point to addressing skills gaps in adult-trained nurses and to reappraising visiting policies.
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Nursing in critical care · May 1997
ReviewNurses' under-medication of analgesia in cardiac surgical patients: a personal exploration.
This paper examines aspects of care which may account for some of the reasons why critical care nurses fail to relieve patients' pain following cardiothoracic surgery. Factors that may influence the critical care nurses' decision regarding the amount of opiate analgesia to give a patient are examined using the 'Theory of Planned Behaviour' as a framework for enquiry. The skills required by the critical care nurse in planning how to play the phenomena of 'the doctor-nurse game' may be a key element in meeting the goal of pain relief for the patient following cardiac surgery.
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Developments in critical care medicine have increased the chances of survival of those patients with severe trauma or established sepsis. However, such patients often have a prolonged critical illness, and the ensuing catabolic response can have detrimental effects causing a depletion of body weight, tissue mass and stored nutrients. In order to facilitate treatment and minimise the effects of these catabolic changes, both the mediators of this response and the response itself have been studied. This paper explores the current understanding of the metabolic changes that occur in trauma and sepsis, and how these changes alter carbohydrate, fat and protein metabolism.
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Our understanding of the concept and definition of death has changed over time. The British contribution to the body of knowledge on the diagnosis of brain steam death was the publication by the medical royal colleges (1976) of diagnostic criteria. ⋯ Several issues which arise from the literature are discussed in relation to organ donation. Further UK-based research is required.