Articles: critical-care.
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The onset of agitation and distress in a mechanically ventilated patient should initiate a careful assessment that considers whether there has been progression of the underlying disease, a new medical complication, or adverse effects from medical interventions and procedures, including intubation and mechanical ventilation. This article focuses on problems that relate to mechanical ventilation and the interactions of the "patient-ventilator system". The authors suggest an initial approach to the patient who develops respiratory distress, and then review the appropriate indications for sedative and paralytic medications.
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To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the ED length of stay and procedures performed in medical critical care patients. ⋯ Critically ill patients spend a substantial amount of time in the ED before transfer to the ICU. Typical ICU procedures are commonly performed. Further study of the impact on patient outcome of ED stay and the procedures performed in critically ill medical patients should be conducted.
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Postoperative pain is one of the major obstacles in the prevention of complications during patient recovery. Pain and its management have gained great interest among researchers, clinicians and policy-makers. ⋯ Certain patient conditions such as length of time after surgery and ventilator status affected nurses' assessment and management of pain. Nurses' knowledge about pain assessment and management may affect patient care and outcomes.