British journal of nursing (Mark Allen Publishing)
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I have to confess that when the first reports of swine flu started circulating, I did have a strong sense of déjà vu - after all, we've been here before. Back in 2003, the world was under threat from another potentially lethal virus that began in an economically deprived part of the world among animal stocks and briefly (according to some anyway) threatened to turn into a global pandemic--Avian flu.
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In this series of articles, the authors outline what they consider to be essential/core critical care skills that all nurses should possess in order to timely and appropriately assess critically ill patients. It is anticipated that the possession of these core skills will enable nurses to appropriately assess and identify those patients who are at risk of deterioration. ⋯ Having covered respiratory assessment here, in subsequent articles the authors will outline and discuss the following key critical care skills that all nurses should possess: cardiac and circulatory assessment, neurological assessment, hydration status assessment, fluid management and intravenous therapy. In this article the authors discuss the airway, breathing and circulation (ABC) approach to patient assessment and then focus on respiratory assessment and management.
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Uncontrolled faecal incontinence (FI) secondary to diarrhoea represents a major risk to perianal skin integrity and the healing of perineal wounds or burns. In an era of heightened awareness of the morbidity and the costs associated with hospital-acquired infection, there are obvious concerns about the risks of cross-infection associated with diarrhoea or FI. This article evaluates the Zassi Bowel Management System (ZBMS, Hollister), a product that has been designed to manage diarrhoea, faecal incontinence and defaecation in situations where a patient is either completely dependent, has overwhelming uncontrolled diarrhoea that poses a threat to skin integrity and is a cross-infection risk, or where normal defaecation poses a risk to wound integrity and sterility.
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Lymphoedema is a condition where there is an obstruction of the flow of lymph, partnered with a swelling of the limb. Within the breast cancer arena lymphoedema can occur in the arm where the cancer was/is. The various approaches to treating lymphoedema include skin care, elevation of the affected arm, the use of compression hosiery, multi-layer bandaging, massage (manual lymphatic drainage), or even surgery. This article will discuss the treatments for lymphoedema along with relevant evidence and illustrate current practice.
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Jehovah's Witnesses believe that an individual's life is contained within blood, and that accepting transfusion of blood and blood products is sinful. The administration of blood to a Jehovah's Witness who has refused to accept transfusion may lead to criminal or civil proceedings. ⋯ Medical and nursing staff faced with such a problem should explore fully with the patient any transfusion alternatives that the patient might find acceptable, such as cell salvage, volume expanders, antifibrinolytics and pharmaceutical options, such as erythropoietin. This article examines the legal and consent issues around blood transfusion in Jehovah's Witness patients and their implications for medical and surgical management.