Critical care nurse
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Neuromuscular blockade is a pharmacological adjunct for anesthesia and for surgical interventions. Neuromuscular blockers can facilitate ease of instrumentation and reduce complications associated with intubation. ⋯ If an operation is particularly complex or requires a long anesthesia time, residual neuromuscular blockade can contribute to longer stays in the intensive care unit and more hours of mechanical ventilation. Given the risks of this medication class, it is essential to have an understanding of the mechanism of action of, assessment of, and factors affecting blockade and to be able to identify factors that affect pharmacokinetics.
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Withdrawal of life support is an option for patients with prolonged mechanical ventilation when all attempts at weaning have failed and it is deemed futile to continue the therapy, when quality of life is unacceptable, or when it is perceived that the patient is suffering. The purpose of this article is to present the nursing aspects of managing an adult patient undergoing the withdrawal of mechanical ventilation as an end-of-life procedure. ⋯ Clear communication with patients and their families can ensure that the process goes smoothly. Having an organized approach can ensure that patients experience a peaceful death and staff experience closure regarding the event.
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Critical care nurse · Jun 2012
Multidisciplinary simulation in pediatric critical care: the death of a child.
Health care providers are trained to care for the living. They may complete their education and enter the workforce without ever experiencing the death of a patient. ⋯ In such situations, the expertise of the multidisciplinary team can make a difference. A multidisciplinary education project that uses high-fidelity simulation based on pediatric death and dying was developed to provide an experience during which health care practitioners could practice communicating with families about the death of their child and dealing with different grief reactions.