Articles: critical-care.
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The results of a national survey of critical-care pharmaceutical services are reported. A questionnaire was mailed on March 8, 1988, to 1500 of the 6800 U. S. hospitals with more than 100 beds. ⋯ There were no differences between satellite and nonsatellite ICU pharmacists in either the percentage of a typical day spent providing clinical services to critical-care patients or the percentage of critical-care patients receiving those services. Respondents expected their hospitals to add 301 full-time-equivalent critical-care pharmacists to their staffs during the next two years, for a 39% increase. Respondents strongly favored establishing 24-hour unit dose drug distribution and i.v. admixture services, providing inservice education to nurses and physicians, and providing written pharmacokinetic consultations.(ABSTRACT TRUNCATED AT 250 WORDS)
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[Psychiatric problems and sleep disorders in surgical intensive care. A polygraphic study: 8 cases].
The patients hospitalized in intensive care units present sleep disorders, mainly a sleep deprivation, particularly in paradoxical sleep. Both on the experimental and clinical plan sleep deprivation has been considered to be responsible for psychotic disorders. Over the past fifteen years these results have been controversial. ⋯ Analysis of these eight cases corroborates the latest experimental résults on sleep deprivation and current methodological considerations. Sleep deprivation in itself does not seem to lead to major psychiatric disorders but it is one of the factors, contributing to genesis of psychiatric troubles in an intensive care unit. The other ones that have been suggested (environment, somatic pathology, psychological ill effects due to the hospitalization) are also quite important.
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Epidural catheters are now beginning to be used to manage pain in the critically ill child. Effective use of epidural catheters and epidural analgesics is a critical care nursing challenge.