Articles: critical-illness.
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The objective of this study was to identify the underlying causes of respiratory-related critical events associated with intravenous patient-controlled analgesia (i.v. PCA). ⋯ Following review of the critical events, it was determined that the design of the PCA device contributed to the misprogramming errors and the device was removed from service. Changes in the training of physicians and nurses were instituted to avoid recurrence of other errors identified. The incidence of serious respiratory-related critical events was 0.1%. i.v. PCA therapy has the risk of potentially serious complications and requires constant physician and nursing care with an active quality assurance program.
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Critical care medicine · Mar 1994
Continuous infusion of haloperidol controls agitation in critically ill patients.
To evaluate the safety and efficacy of continuous infusion of haloperidol in treating agitated critically ill adult patients. ⋯ Continuous infusion of haloperidol effectively controls severe agitation in critically ill patients, reduces requirements for bolus administration of sedatives and nursing time lost to that task, and may facilitate ventilator weaning. Parenteral administration of haloperidol was associated with few complications in > 1,340 patient-hours of continuous administration.
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Comparative Study
The use of analgesics and sedatives in critically ill patients: physicians' orders versus medications administered.
To examine the difference between the prescribed and actually administered dose of analgesic and sedative drugs in critically ill patients. ⋯ Physicians tended to write fairly nonspecific orders that were used by the nursing staff as very broad guidelines. A need exists to educate physicians as to what patients actually receive for sedation and analgesia and at the same time improve the dialogue between nurses and physicians as to what patients actually require.