Journal of post anesthesia nursing
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Most PACUs are accustomed to rapidly weaning patients who arrive on mechanical ventilators. However, as the acuity of patients in the PACU continues to increase, the ability to quickly wean patients to extubation is becoming less possible. The difficult-to-wean patient population is requiring the PACU nurse to become more astute in assessing and planning the weaning process. A collaborative approach can facilitate the successful weaning of a patient from the ventilator.
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Randomized Controlled Trial Comparative Study Clinical Trial
Forced-air warming versus routine thermal care and core temperature measurement sites.
Hypothermia occurs commonly during the perioperative period and is preventable with proper warming measures and body temperature monitoring. Using a prospective, randomized study design, we compared forced-air warming (Warm Touch, Mallinckrodt Medical, Inc, St Louis, MO) (n = 15) with routine thermal care (n = 14) during the intraoperative and early postoperative periods. The results show that compared with routine thermal care, forced-air warming resulted in higher core temperatures both intraoperatively and postoperatively. ⋯ Assuming tympanic temperature is most representative of "core" temperature, oral measurements were likely to underestimate core temperature, whereas bladder and rectal temperatures overestimated core temperature. The relationship between body temperatures measured at commonly used monitoring sites must be recognized by nurses to account for the tendency to overestimate or underestimate core temperature. This knowledge can be applied in the management of patients in the operating room or PACU and specifically in the evaluation of PACU patients before discharge.
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Randomized Controlled Trial Clinical Trial
Music reduces stress and anxiety of patients in the surgical holding area.
Many patients in the Surgical Holding Area become stressed and anxious. In a hospital setting music reduces patients' anxiety. This study determined that music can reduce the anxiety and stress of patients in the Surgical Holding Area. ⋯ Subjects who listened to music while in the Surgical Holding Area had significantly less stress and anxiety than did those who did not listen to music. Both groups spent similar lengths of time in the Surgical Holding Area. The results strongly suggest that if music were available to all patients in the Surgical Holding Area, most would select this option, and they would experience less anxiety.
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The intercostal nerve block is an effective and relatively safe intervention for postoperative pain control after upper abdominal and thoracic surgery. It may be done in the operating room or in the PACU. Understanding the mechanics of the technique can help to improve care of patients receiving this intervention.