Aust Crit Care
-
Nurses are required to recognise early clinical deterioration in patients and call emergency support. Nurses often use the subjective non-specific criterion, 'concerned about the patient' as the indication for calling. No study has identified cues of relevance to this criterion. ⋯ The ten changes of concern (cues) can be considered precursors of potential early deterioration that may assist nurses to detect patients at possible risk. Nurses are also aware that some patient groups are at higher risk as they are not able to communicate potential deterioration as perhaps other patients can. This study has only identified two patient groups and it is possible others should be considered. The availability of identified precursors indicates their validity for recognizing possible early clinical deterioration should be investigated further.
-
Hyperchloraemic metabolic acidosis (HMA) can occur in diabetic ketoacidosis (DKA), from urinary loss of bicarbonate precursors as ketones, or iatrogenically from chloride administration. ⋯ The anion gap (AG) normalises earlier than bicarbonate in children with DKA treated with normal saline, and children with persisting HMA recover from acidosis more slowly.
-
Advanced life support (ALS) assessments are performed to assess nurses' abilities to recognize cardiac arrest events, and appropriately manage patients according to resuscitation guidelines. Although there is evidence for conducting assessments after initial ALS education, there is little evidence to guide educators about ongoing assessments in terms of methods, format and frequency. The aim of this study was to determine methods used by educators to assess ALS skills and knowledge for nurses in Victorian intensive care units. ⋯ Consideration should be given to the purposes and methods of conducting annual ALS assessments to ensure resources and strategies are directed appropriately. To encourage nurses to retain ALS skills and knowledge, regular practices are recommended as an alternative to assessments. However, further research is required to support this notion.