Aust Crit Care
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Review Comparative Study
Nasopharyngeal oxygen (NPO) as a safe and comfortable alternative to face mask oxygen therapy.
Nasopharyngeal oxygen (NPO) therapy is an emerging alternative to conventional face mask oxygen administration. It warrants consideration for treating hypoxaemia when face mask therapy is impractical or when patient intolerance or non-compliance regularly interrupt treatment. ⋯ Therefore, NPO, administered via a fine catheter advanced into the nasopharynx, should be considered when face masks (FMs) or nasal prongs (NPs) are impractical or poorly tolerated and, because of its effectiveness and improved comfort, in patients for whom traditional non-invasive oxygen therapy is indicated. Implications for resource utilisation and costs also exist.
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The study sought to investigate the perceptions and experiences of nurses practising in adult intensive care units (ICUs) with regard to medical futility. A qualitative exploratory descriptive design was used, providing a framework which enabled information to be gathered on a relatively undefined phenomena. Data were gathered via semi-structured interviews with seven intensive care nurses. ⋯ Understanding patients' views about treatment limitation is important in deciding whether treatment is medically futile. To do this, an inclusive decision making process should be developed by ICUs which incorporates nursing and family input. Experienced ICU nurses can have a significant impact on the management of futile cases; they need to share their understanding of the processes surrounding medical futility and assist junior nurses in negotiating the difficult challenges encountered in decision making and treatment withdrawal.
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This study assessed the current practices of heparin dosing and determined the extent of therapeutic activated partial thromboplastin times (aPTT) achieved, utilising a standard heparin nomogram in the coronary care unit and step-down cardiac ward of a health care facility in South Australia. The study also examined the effect of actual body weight (ABW), body mass index (BMI), smoking, concomitant intravenous glycerine trinitrate, age, gender and creatinine levels, individually, on the time taken to attain a therapeutic aPTT in acute coronary syndrome (ACS) patients receiving a heparin infusion. A retrospective correlational research design was utilised to include the collection of quantitative data from 66 men and women of all ages and background consecutively admitted into the coronary care unit and the step-down cardiac ward and receiving a continuous heparin infusion. ⋯ Age (p=0.668), gender (p=0.623), smoking (p=0.993) and the use of concomitant intravenous glycerine trinitrate (p=0.897) did not have a significant effect on the time to reach a therapeutic aPTT. The results provide noteworthy information for the re-evaluation of the use of the standard heparin nomogram. A robust randomised clinical trial is required to further examine BMI as the best predictor for heparin requirements in ACS patients receiving a heparin infusion.