Articles: critical-care.
-
Anesteziol Reanimatol · Mar 1994
Review[The use of hypertonic sodium chloride solutions in resuscitation, intensive therapy and disaster medicine].
The review of Russian and foreign literature published in 1939 to 1993 has demonstrated possible use of small doses of isotonic salt solution for prompt correction of hemodynamic parameters in severe traumas, massive blood loss, most severe stages of shock and critical conditions. The best effect can be achieved with the use of isotonic salt solutions in combination with hyperoncotic solutions (sodium chloride and low molecular weight dextran). The principal mechanism of action is attraction of the liquid from the interstitial spaces into the vascular bed, stimulation of vascular osmoreceptors and neurogenic reflex mechanisms. High efficacy, simplicity and acceptability of the technique make it possible to recommend it for the use at prehospital stage, immediately on the spot of the accident, during transportation and at hospital stage when there are numerous patients with severe traumas and shortage of infusion-transfusion media.
-
Intensive Crit Care Nurs · Mar 1994
Ethical decision-making in intensive care: a nurse's perspective.
Technology has increased our ability to sustain life, but to what end? Ethical dilemmas abound in intensive care units (ICUs), but in the author's experience nurses are rarely formally involved in ethical decision-making. Should nurses be involved? This article is an attempt to answer this question by considering the unique position of an intensive care nurse, the stress caused by ethical dilemmas, the ethical and legal responsibilities of the nurse and the educational and psychological factors influencing the decision-making process. The current involvement of nurses in ethical decision-making is reviewed and a framework for ethical decision-making is suggested. Implications for education and practice are drawn from the discussion.
-
The aim of this study was to investigate the attitudes of critical care nurses and doctors to parasuicide patients. A survey was conducted of 299 nurses and 81 doctors working in emergency departments and intensive care units of nine Victorian hospitals. Data obtained from responses to a Likert-type questionnaire were assessed in order to explore relationships between the doctors' and nurses' attitudes and demographic and other variables. ⋯ Nurses were also significantly more likely than doctors to self report that they were afraid of saying the wrong thing to these patients. Eighty three percent of nurses and 61% of doctors stated that they would benefit from suicide related education. Addressing this expressed need must be a high a priority for critical care units if parasuicide patients are to receive more individual and appropriate care and if their carers are to experience greater work satisfaction.
-
Randomized Controlled Trial Clinical Trial
[The effect of theophylline on the mucociliary clearance function in ventilated intensive care patients].
Mucociliary clearance represents an important protective mechanism of the upper and lower respiratory tracts whereby inhaled particles and micro-organisms are removed from the tracheobronchial system. In incubated intensive care unit (ICU) patients, impaired ciliary function and mucus transport are associated with pulmonary complications [9]. Some authors have shown that theophylline increases mucus transport in healthy subjects and patients with chronic bronchitis [8, 16, 31, 36]. ⋯ CONCLUSIONS. Theophylline at therapeutic concentrations improves bronchial mucus transport in intubated ICU patients. The increase in BTV may be associated with severe tachycardia, and therefore routine application cannot be recommended.