Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 1998
ReviewIntensive nursing care of patients with a microvascular free flap after maxillofacial surgery.
This article provides an introduction to the care of patients following maxillofacial surgery, many of whom undergo the complexities of microvascular flap surgery and need careful nursing assessment in the postoperative period. A brief introduction to this surgery illustrates some of the potential reasons for admission to the intensive care unit. The nursing care is vital to maintain the survival of the flap, the details of which are discussed along with factors which potentially contribute to flap failure. Other considerations such as haemodynamic stability, postoperative complications, the importance of education and other options for postoperative management also form further points for discussion.
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Intensive Crit Care Nurs · Aug 1998
ReviewIs a murder charge an occupational hazard of intensive care nursing?
When nurses are accused of harming their patients there is an understandable wave of concern. When nurses kill their patients there is disbelief and horror. After all, killing patients is so far from the traditional image of the nurse as to cause distress and disorientation. ⋯ In the UK, of the nurses accused of attempting to murder their patients two came from the same specialism. Two of the three accusations centred on Intensive Care Units (ICU); the case of Amanda Jenkinson (Kenny 1996) and the case of Kath Atkinson, an ICU sister in Newcastle (Porter 1998a). In the most notorious case of nurse homicide in the UK this decade, that of paediatric nurse Beverly Allitt, the profession and society at large were shaken by accusations so serious as to defy belief.
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Intensive Crit Care Nurs · Apr 1998
ReviewNeeds of the critically ill child: a review of the literature and report of a modified Delphi study.
There has been a wealth of guidance from both policy-makers (Department of Health, (DoH) 1991, DoH 1997a, DoH 1997b) and other interested parties (Audit Commission 1993, British Paediatric Association 1993, Paediatric Intensive Care Society 1992) regarding how and where care should be provided for critically ill children. Latest recommendations indicate that designated general ICUs will continue to provide care for children requiring life support and that all general ICUs will need to initiate such care (DoH 1997a). ⋯ This paper explores the literature regarding the needs of the critically ill child, incorporating the role of parents and previous studies exploring needs. The findings of a modified Delphi study exploring the needs of the critically ill child are also outlined.
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Intensive Crit Care Nurs · Oct 1997
ReviewPhysiological changes occurring with positive pressure ventilation: Part one.
Critically ill patients requiring mechanical ventilation are subject to a variety of complications and adverse effects associated with positive pressure ventilation. An awareness of the major physiological effects is important, as recognition, prevention and appropriate treatment of complications is critical to optimizing patient outcome. Pierson (1990) suggests that complications due to ventilation occur with greater frequency than is generally appreciated, and can be a response to suboptimal ventilatory management as a result of poor communication and lack of understanding. ⋯ This increases the nurses' confidence and allows them to focus on the patients and associated problems while maintaining safe and informed care. With the introduction of mechanical ventilation, major physiological changes occur, for example airway resistance and intrathoracic pressures are increased and lung mechanics are altered. The following article provides explanation as to how and why mechanical ventilation produces these changes, and highlights areas where they occur.
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Intensive Crit Care Nurs · Aug 1997
ReviewAspects of pulmonary artery catheterization in critical care.
The concept of floating a balloon-tipped catheter into the pulmonary artery was first described in 1970 by Swan et al. Since then, many issues have surrounded the use of these catheters. Of particular concern for many physicians was the incidence of complications associated with use of the catheters. ⋯ Training nurses to use a PAC correctly has been highlighted in reducing the number of technical problems associated with the catheter, which in turn improves the accuracy of haemodynamic data obtained. Unfortunately, training programmes are few and far between, and this is an issue that must be addressed by critical care nurse managers. In this review of the literature regarding PACs and their use in the care of the critically ill patients, the role of the nurse is discussed with recommendations for practice.