Articles: critical-care.
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Critical care medicine · Oct 1994
Assessment of critical care nurses' knowledge of the pulmonary artery catheter. The Pulmonary Artery Catheter Study Group.
To assess the knowledge and understanding of the use of the pulmonary artery catheter and interpretation of data derived from it in a group of nurses attending the American Association of Critical Care Nurses' National Teaching Institute conference. ⋯ A wide variation in the understanding of the use of the pulmonary artery catheter exists among nurses using this device in the care of seriously ill patients. The results indicate that current teaching practices regarding the pulmonary artery catheter need to be reevaluated and specific credentialing policies need to be considered.
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The study presented investigates prospectively the clinical value of the PMN-elastase as a sequel parameter in 954 patients of a surgical intensive care unit. The elastase-values measured discriminate highly significant between patients with and without complications (p < 0.001) as well as between survivors and non-survivors (p < 0.001). Furthermore in patients underlying shock-phases in the course of treatment significantly higher elastase values are measured as in the patients remaining (p < 0.001). The highest prognostic evidence is determined by the elastase at the 9th day of course of disease concerning the prediction of a patient's death (sensitivity 78%, specificity 75%, positive predictive value 63%, respectively negative predictive value 87%).
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To be in respiratory distress is to be anxious. To be mechanically ventilated is to be grossly uncomfortable at best. To undergo weaning in the presence of possible severe respiratory compromise, again, inevitably is anxiety provoking. ⋯ The anxious patient has difficulty cooperating with weaning and respiratory toilet. The delirious patient cannot cooperate with anything. Until these agitated behaviors are differentiated and resolved, the patient remains at respiratory risk.
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With the increase in the number of critically ill patients needing extended periods of time in the ICU and the subsequent shortage of ICU beds, hospitals have examined ways to use the PACU as an alternative for the short-term critically ill patient. This article identifies common problems encountered by the PACU staff, and the author suggests criteria for establishing and implementing guidelines for successful integration of these short-term critically ill patients without losing sight of the PACU's goals and compromising patient care. The criteria for establishing guidelines were based on the personal experience of the author in developing a program for ICU overflow patients, as well as from experiences of other PACU nurses working in PACUs where successful guidelines currently are used.