Articles: patients.
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Since 1982 an emergency ambulance manned by a physician and two emergency medical technicians has been operated in the Reykjavik area. The physicians have followed guidelines from the American Heart Association (AHA). Until 1986 the AHA guidelines had bicarbonate and in some instances calcium as first line treatment in cardiopulmonary resuscitation (CPR). ⋯ When sudden cardiorespiratory arrest is witnessed the probability of survival is multiplied. We conclude that the results of ACLS outside the hospital in Reykjavik and surrounding area continue to be among the best. Changes in ACLS guidelines do not appear to have increased survival.
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Journal of anesthesia · Jan 2000
Effects of sevoflurane and isoflurane on the ratio of cerebral blood flow/metabolic rate for oxygen in neurosurgery.
To examine the changes in cerebral blood flow (CBF) equivalent (CBF divided by cerebral metabolic rate for oxygen) during craniotomy under isoflurane and sevoflurane anesthesia in patients with intracranial disorders. ⋯ Deepening anesthesia from 0.5 to 1.0 MAC was maintained with no difference between the two agents during 4h of neurosurgery.
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Neuropathic pain is a challenge for clinicians because it is resistant to commonly prescribed analgesics, such as opioids and nonsteroidal antiinflammatory drugs. Fortunately, adjuvant analgesics, drugs not typically thought of as pain relievers, may be effective. It is helpful to classify adjuvant analgesics used to treat neuropathic pain into two broad categories: (1) membrane stabilizing agents, which inhibit ectopic discharges on damaged neural membranes, and (2) drugs that enhance dorsal horn inhibition, which may augment biogenic amine or GABAergic mechanisms in the dorsal horn of the spinal cord. ⋯ Although polypharmacy is the result, this approach may improve therapy and minimize side effects. From a safety standpoint, medications generally should be started at low doses and titrated to effect. Although labor-intensive, this strategy can improve compliance and optimize patient care.
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Journal of anesthesia · Jan 2000
Unanswered and uncounted items of the illness behavior questionnaire count: a comparison between patients who answered all the items in the questionnaire and those who left one or more items unanswered in a pain management program.
This study aimed to understand the significance of unanswered and uncounted items on the illness behavior questionnaire (IBQ) in the setting of the Mayo Clinic pain management program for patients with chronic pain. ⋯ Unanswered and uncounted items of the IBQ seem to count toward a better understanding of patients' pain behavior.
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Clin Excell Nurse Pract · Jan 2000
Literacy for health information of adult patients and caregivers in a rural emergency department.
The nurse practitioner is responsible for providing the patient and family with understandable written information before discharge from the emergency department (ED) following an acute event. Patients are more likely to adhere to their treatment regimen and follow-up if they have a clear understanding of their instructions. Patients cannot correctly interpret information they cannot read. ⋯ The REALM scores placed the reading level of the sample at between seventh and eighth grade. The preprinted discharge instruction forms used by the three rural hospitals had a Flesch-Kincaid grade level of 9.0, a reading level higher than 62% of the sample. By ensuring discharge instructions are developed at a reading level of sixth grade or below, nurse practitioners can provide teaching materials that encompass the reading levels of the majority of the rural ED population.