Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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End-of-life care for trauma patients is unique in that clinicians rarely have the advantage of knowing victims prior to the event. In this setting, the unfamiliarity with patients' wishes and values, the critical nature of the injury, the overwhelming feelings of guilt that families often experience, the suddenness and acuity of the crisis, and the need to make life-and-death decisions, can result in end-of-life care scenarios that are challenging to manage and often difficult to experience. This article describes a plan to develop, implement, and test a best practice model of end-of-life care for trauma victims and their families.
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The Glasgow Coma Scale (GCS) is an easy to use tool for assessing neurological function and brain injury in comatose patients particularly in acute stages of traumatic injury or illness. Due to the simplicity of the scale, however, proper training is often overlooked limiting its usefulness. This manuscript describes the basic components of the GCS and the proper scoring method to elicit accurate evaluations.
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Abdominal compartment syndrome in the trauma patient is usually associated as a post surgical complication or as a consequence of full thickness burns to the trunk and abdomen. It is not widely recognized in patients who have received massive fluid resuscitation in the absence of abdominal pathology. This paper will present a case study of a pediatric patient who was the victim of a motor vehicle collision. ⋯ The patient underwent abdominal decompression and returned to the pediatric intensive care unit with an open abdomen covered with a temporary dressing. Differences in pediatric anatomy and physiology which can predispose children to this condition will be explained. In addition pathophysiologic responses to trauma that contribute to abdominal compartment syndrome and nursing care of this condition will be explored.
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Capnometry is a useful tool for emergency airway and ventilation management. Advantages include high sensitivity and specificity with regard to ET tube placement and the ability to provide continuous data throughout the initial resuscitation. Ultimately the ability of capnometry to guide ventilation and even chest compressions may be its most important contribution to the care of critically ill and injured patients.