Heart & lung : the journal of critical care
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Multicenter Study Clinical Trial
Implementation of a pain management algorithm in intensive care units and evaluation of nurses' level of adherence with the algorithm.
To implement a pain management algorithm in intensive care units (ICU) and to evaluate nurses' level of adherence with the algorithm. ⋯ ICU nurses can use a pain management algorithm consistently. Findings from this study suggest that a pain management algorithm is a useful tool to increase ICU nurses' adherence with pain assessment.
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Mechanical ventilation (MV) causes many distressing symptoms. Weaning, the gradual decrease in ventilator assistance leading to termination of MV, increases respiratory effort, which may exacerbate symptoms and prolong MV. Music, a non-pharmacological intervention without side effects may benefit patients during weaning from mechanical ventilatory support. ⋯ Evidence supports music as an effective intervention that can lesson symptoms related to MV and promote effective weaning. It has potential to reduce costs and increase patient satisfaction. However, more studies are needed to establish its use during MV weaning.
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Pragmatic Clinical Trial
Quality of care and resource use among mechanically ventilated patients before and after an intervention to assist nurse-nonvocal patient communication.
Implement and test unit-wide patient-nurse assisted communication strategies (SPEACS). ⋯ SPEACS improved ICU nurses' knowledge, satisfaction and comfort in communicating with nonvocal MV patients but did not impact patient care quality or resource use.
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To describe alternative non-pharmaceutical non-nutraceutical pain self-management strategies used by people with heart failure (HF) in order to reduce chronic non-cardiac pain. ⋯ Patients with HF and chronic pain use few alternative pain treatments. Screening for chronic pain and referral to Integrative Medicine and/or Palliative care for a pain management consult might reduce the added burden of pain in people with HF.
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Case Reports
Emergent echocardiography and extracorporeal membrane oxygenation: Lifesaving in massive pulmonary embolism.
Massive pulmonary embolism is a life-threatening emergency that results in circulatory failure. The main challenges in management are early diagnosis and maintenance of hemodynamic stability. ⋯ We were able to maintain hemodynamic stability and improve hypoxia until the patient underwent embolectomy. This case demonstrates a common presentation of massive pulmonary embolism highlighting the main challenges in its management and the role of echocardiography and ECMO in improving outcomes in such scenarios.