Articles: critical-care.
-
Pulmonary contusion, known as the most common potentially lethal chest injury seen in this country, necessitates aggressive nursing assessment and diagnosis if treatment is to be effective and prognosis improved. Initial chest x-rays will usually not display the severity of the contusion. ⋯ By monitoring ventilatory parameters to assess oxygenation, the nurse acknowledges that hypoxemia is the hallmark clinical sign. Through comprehension of the different mechanisms of injury, the role of chest compliance, and the pathologic alterations, the critical care nurse delivers skillful and knowledgeable care to the patient with a pulmonary contusion.
-
The American surgeon · Jun 1991
The utility of cardiac evaluation in the hemodynamically stable patient with suspected myocardial contusion.
Myocardial contusion following isolated blunt thoracic trauma (BTT) remains a diagnostic and therapeutic dilemma. To identify the presence of cardiac abnormality following BTT, 123 hemodynamically stable patients were prospectively evaluated with serial electrocardiograms (ECG) and cardiac enzymes (total CPK and CPK-MB). Gated cardiac radionuclide angiography (MUGA) scans were performed within 48 hours following admission. ⋯ MUGA scan was abnormal (right ventricular ejection fraction less than 40 per cent and/or wall motion abnormality) in 12 patients (19%). Eight patients with MUGA scan abnormality had normal ECG and/or normal total CPK, CPK-MB values. Evaluation of all patients up to six months revealed no mortality, malignant arrhythmias, or cardiac failure.(ABSTRACT TRUNCATED AT 250 WORDS)
-
The regionalization of trauma care has led to a decrease in preventable death after injury. This decrease has been attributed to earlier resuscitation and surgical intervention. Little emphasis, however, has focused on the critical care phase of trauma patient management. ⋯ The proportion of preventable deaths attributable to CCEs was higher than the proportion of preventable death attributable to errors in the resuscitative and operative phases of care (p less than 0.001, chi-square). These data indicate that CCEs significantly contribute to preventable mortality and morbidity in trauma patients. It is imperative that physicians caring for trauma patients possess expertise in the critical care management of injured patients.
-
Successful treatment of acute intoxications should include early urgent measures, use of specific antidotes, polysymptomatic and polysyndromic treatment. It is an error to delay intensive care until laboratory identification of the toxicant. Only combined use of methods directed to potentiate natural urocesses, intra--and extracorporal detoxication allows to improve treatment results of treating acute intoxications.