British journal of nursing (Mark Allen Publishing)
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The number of violent crimes in Great Britain is on the increase and therefore there is a possibility that nurses will encounter a casualty with stab or gunshot wounds. On encountering a casualty with stab or gunshot wounds, the first aider must immediately assess the scene to avoid personal injury or risk to life. No matter how ugly or bad the injuries look, the basic principles of first aid still apply. ⋯ Any penetrating injury to the chest may result in instant respiratory distress. Make use of people present at the scene of the injury. Always ensure that the emergency services are notified immediately.
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Documented assessment of pain does increase patient satisfaction in pain control and treatment but it must be carried out regularly and, more importantly, it must be acted upon. Patients who participate in documented assessment of pain postoperatively may find it easier to communicate their pain levels to the nurse, may feel more informed about their treatment and may be given analgesia more quickly than a control group. Nurses are aware of the importance of pain intensity assessment but do not always assess the effectiveness of the analgesia given. ⋯ Pain cannot be treated or controlled if it is not accurately assessed. Any information given before surgery decreases anxiety levels and therefore lessens the patient's perception of pain postoperatively, particularly when the information is related to how and where the patient may feel pain. The use of documented pain assessment combined with patient-controlled analgesia systems may be the key to effective postoperative pain control.
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Each individual has the right to a dignified death, which may necessitate a decision to cease active treatment. The key to making such a decision is communication between professionals, child and family. Ethical principles may help to provide a basis and structure for decision making. ⋯ The nurse is responsible for updating him/herself on ethical issues, and acquiring the knowledge necessary to represent both the child and his/her colleagues in discussion. Withdrawal of aggressive care does not mean abandoning the child and family. On the contrary, all the skills and resources available will be required to ensure a peaceful and dignified death, and to support the child and family.