Articles: critical-care.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Aug 1994
[Modification of ventilation and length of stay of traumatized intensive care patients by quality and duration of preclinical management].
The study aimed at detecting relations between the quality and duration of prehospital care in the case of traumatic patients and the duration of artificial respiration and ICU stay times. ⋯ Quality and duration of the prehospital care were identified as factors, influencing the time of the ICU stay. Optimizing these factors will be helpful in respect of economic considerations.
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Review
Clinical manifestations of blunt cardiac injury: a challenge to the critical care practitioner.
Life-threatening cardiac emergencies following blunt chest trauma demand accurate assessments and rapid interventions to prevent unnecessary complications and death. Critical care practitioners must recognize the subtle clues that indicate cardiac trauma and the decompensation that occurs if the injuries are not recognized early. ⋯ Traditional diagnostic laboratory studies such as cardiac enzymes have proven ineffective in the trauma patient population. Therefore, the role of the critical care practitioner is centered on assessing patients for the clinical manifestations of decreased myocardial performance, particularly those patients with limited cardiac reserve.
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Progress in cancer surgery and changes in philosophy have resulted in greater numbers of critically ill surgical oncology patients. The effects of cancer and prior exposure to cancer therapies increase the risks for postsurgical problems. Life-threatening cardiopulmonary sequela and patients undergoing liver resections and transplantation are examples of problems that require the knowledge and skill of critical care nurses. Critical care surgical nurses face new challenges by merging their surgical nursing expertise with principles of cancer care.
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Patients with significant abdominal trauma and polytrauma patients with less severe abdominal injuries require critical care management. The diagnostic skills used for the initial evaluation of the injured abdomen are used to determine whether celiotomy is required and to evaluate the postoperative abdomen for missed injury or early detection for complications. The critical care nurse must identify life-threatening abdominal injuries immediately and all abdominal injuries in a timely fashion through consideration of the mechanism of injury and a combination of history, physical examination, and diagnostic tests. All facets of the critical care management of abdominal trauma must be familiar to the critical care nurse in order to recognize abdominal injuries and lower the frequency of preventable death after trauma.
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Critical care medicine · Aug 1994
Intravenous lorazepam as an amnestic and anxiolytic agent in the intensive care unit: a prospective study.
To assess the efficacy and hemodynamic safety of intravenous lorazepam as an amnestic and anxiolytic agent in patients undergoing critical care procedures. ⋯ This study confirms the beneficial anxiolytic and amnestic effects of lorazepam in a subgroup of patients undergoing critical care procedures. The study also substantiates the safety of this drug in this patient population.