Articles: intensive-care-units.
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Intensive Crit Care Nurs · Mar 1994
A study into the uses and effects of do-not-resuscitate orders in the intensive care units of two teaching hospitals.
Do-not-resuscitate (DNR) orders pose many ethical and moral dilemmas for health professionals. When placed in the context of an Intensive Care Unit (ICU), these dilemmas are magnified. Data were obtained on all admissions to two ICUs over a 3-month period, using a descriptive survey design. ⋯ In six (24%) cases DNR orders were verbal only. These units demonstrate generally good practice regarding DNR decision-making and nursing care. However, explicit documentation is necessary in all cases.
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The most important epidemiological, aetiological and diagnostic problems related to nosocomial pneumonia in the intensive care unit and its significance are reviewed. Areas of uncertainty are identified, as are methods for improving our understanding of this complex condition.
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Neuromuscular blocking agents (NMBAs) are commonly prescribed as adjunct therapy for many critically ill patients. Controversy exists regarding the appropriate long-term use of these agents, particularly since there are severe potential clinical consequences. The expanded use of NMBAs has had a significant effect on the cost of ICU care. ⋯ This article reviews some of the indicative economic issues surrounding the use of sedatives, analgesics, and NMBAs in the critical care arena. Understanding the pharmacokinetic and pharmacodynamic differences of these agents can aid in drug selection and route of administration. Appropriate drug selection can influence the pharmacoeconomics of these agents in the ICU.
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Neonatal and pediatric critical care units are growing in size and complexity. Each unit is staffed by a highly specialized group of nurses. Although the units share many commonalities, the relationship between nurses in the neonatal and pediatric critical care units often is characterized by rivalry and antagonism rather than by cooperation. The purpose of this report is to identify similarities and differences between the two units and to describe the benefits of collaboration between units.