Articles: critical-care.
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Critical care medicine · Jul 1991
Measurement of systolic blood pressure using pulse oximetry during helicopter flight.
Monitoring of vital signs in critically ill patients during helicopter flight is difficult because of the noise and vibrations of the aircraft. We evaluated the use of a pulse oximeter to measure systolic BP intraflight. ⋯ We conclude that a pulse oximeter that displays a plethysmographic waveform can accurately measure systolic BP intraflight.
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A preliminary study was performed to calculate the cost of intensive therapy on an individual patient basis. The fixed (equipment, supporting services and land opportunity), semi-fixed (staff) and marginal (treatment) costs of 20 critically ill patients were calculated individually. The results show that there is wide variation in intensive therapy costs. ⋯ The mean total cost per patient was 1980 pounds, but the cost per survivor increased by 16% (347 pounds) because of four deaths on the intensive care unit. High total costs are associated with increased severity of illness and higher marginal (treatment) costs are associated with increased semi-fixed (staff) costs. The cost of intensive therapy was three to five times that for general ward care.
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J Burn Care Rehabil · Jul 1991
Use and efficacy of a nutrition protocol for patients with burns in intensive care.
The University of Michigan Burn Center uses a protocol to standardize the assessment, initiation, and monitoring of nutritional support for patients with burns of greater than 30% total body surface area (TBSA). Six patients with 20% to 80% TBSA burns were followed for 3 weeks to determine the effect of the protocol on the assessment, initiation, monitoring, and adequacy of nutritional support. The protocol calls for resting energy expenditure (REE) measurement within 24 hours of injury, to be repeated 3 times per week, for assessment of caloric requirements. ⋯ Overall, the six patients received enterally an average of 75% of their caloric requirements. The major reason for inadequate enteral support was interruption of tube feedings because of tube dislodgment or multiple surgical procedures. The protocol used weekly measurements of total iron-binding capacity and prealbumin level s parameters of nutritional support.(ABSTRACT TRUNCATED AT 250 WORDS)
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It is important for the critical care nurse to consider the family of the patient in all phases of care to the individual within the critical care setting. The family's structure and usual patterns of functioning will be significantly altered by the illness of one member. By using an "Orientation to the Critical Care Unit" program for the family as well as the impact variables involved, the nurse is better able to assist the family cope with the situation within. (This video orientation program was implemented at a hospital in Northeastern Ohio in 1988 and is currently being shown to families of critical care patients. Feedback from nursing staff and family members has proven to be very positive.