Articles: intensive-care-units.
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Intensive care nursing · Sep 1990
Case ReportsThe use of a multidisciplinary group meeting for families of critically ill trauma patients.
Family members of any trauma patient admitted to the Level I trauma center are invited by the trauma staff to attend weekly multidisciplinary meetings. By the use of these meetings, family concerns can become a positive care factor and the tasks of nurses, doctors and social workers alike made easier.
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The purpose of this study was to describe various dimensions of the pain experiences of intensive care unit (ICU) patients. A purposive, primarily surgical sample of 24 ICU patients from two hospitals was interviewed after transfer from ICU. All but one patient remembered their ICU stay. ⋯ Results of this study clearly indicate that not only pain but its communication and treatment were significant problems for a substantial portion of this ICU sample. Further descriptive and experimental research of pain characteristics and treatment practices for ICU patients is urgently needed. Improvements in nursing practice that result from such research may make a substantial difference in the comfort and well-being of critically ill patients.
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Gen Hosp Psychiatry · Sep 1990
Factors affecting length of stay in a psychiatric intensive care unit.
As a response to the challenge posed by an increasing number of agitated and violent patients, there is in Canada a growing number of psychiatric intensive care units (PICUs), in both general and psychiatric hospital settings. In this article, the functioning of such a unit in a general hospital context is reviewed. ⋯ The factors influencing the functioning and LOS of this PICU are analyzed. A possible "deskilling" of the staff in other wards is discussed, and alternative explanations are hypothesized in an attempt to shed light on the interaction between this unit and its environment.
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Semin Respir Infect · Sep 1990
ReviewHost responses in mediating sepsis and adult respiratory distress syndrome.
Despite significant advances in intensive care unit technology and mechanical ventilatory support, mortality due to adult respiratory distress syndrome (ARDS) or multiorgan failure (MOF) has not changed significantly within the past two decades. The key to improving survival requires understanding and modifying (or eliminating) factors that may initiate (or modulate) these syndromes. Infection, and the host responses to infection, are major etiological factors responsible for the induction and perpetuation of the injury to the lung and microvasculature in ARDS and MOF, and contribute to late mortality. ⋯ Interactions between these humoral and cellular mediators appear to set in motion an amplified cascade of events culminating in cellular and tissue injury. In this article, several of these putative inflammatory mediators are discussed in detail, and the importance of cytokine networking and the possible role of nonimmune cells in the orchestration of the inflammatory response associated with ARDS and MOF are explained. Finally, future therapeutic strategies aimed at blocking or suppressing the release or effects of endogenous mediators may be the key to improving the outcome of these disorders.
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Census fluctuations and the failure to develop appropriate guidelines for admitting and transferring patients have made the staffing of critical care units extremely difficult, sometimes with serious ethical and physical consequences to patients. In this report, a case is analyzed to explore some of the ramifications of the use of beds in the critical care unit.