Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Jun 1997
ReviewFocus of nursing in critical and acute care settings: prevention or cure?
The fluidity of the boundaries of critical and acute care can lead to challenges for nurses working on acute general wards when caring for post-critical care patients and for those in whom a critical care situation arises during a period of acute care. The development and use of critical care skills pose special difficulties for acute care nurses, because of the acuteness and infrequency of such incidents and the diversity of skills the nurses need to possess. Nonetheless, critical care is an important component of an acute ward nurse's repertoire, particularly in relation to preventing episodes of critical illness. ⋯ They may, in addition, lead to an over-reliance on the use of such facilities and must be implemented carefully in order to bridge, rather than widen, the gap between acute and critical care. Critical care is used in this paper as a global term, to encompass all settings where patients are usually more highly dependent and critically ill than patients on general wards. It includes intensive therapy, high-dependency, coronary care and other specialist critical care units.
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Intensive Crit Care Nurs · Feb 1997
ReviewCritically ill children: the case for short-term care in general intensive care units.
This paper contests the claim that all children should be nursed in paediatric intensive care units (PICUs). Although there is an undoubted need for prolonged care to be undertaken within PICUs, they are a scarce resource and many children's critical illness is of short duration. Following a discussion on the negative aspects of transferring a critically ill child this paper then establishes how a general intensive care unit (GICU) can maintain-awareness and standards which make it a safe environment for children with a short-term critical illness, as well as contribute towards future management and practice.
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Intensive Crit Care Nurs · Oct 1996
ReviewEndotracheal suctioning in adults with severe head injury: literature review.
Endotracheal suctioning is a routine but potentially dangerous nursing procedure. The research literature documenting approaches to minimising the complications of endotracheal suctioning in adults with severe head injuries is reviewed. Hyperoxygenation, hyperventilation, hyperinflation, normal saline instillation and the effects of endotracheal suctioning on intracranial pressure and cerebral perfusion pressure are examined. Recommendations for an evidence-based endotracheal suctioning protocol are made.
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Intensive Crit Care Nurs · Oct 1996
ReviewChanging ventilator tubing circuits every seven days versus every 72 hours: proposed practice based on literature review.
The changing of ventilator circuitry is a costly, time-consuming exercise. The current practise of changing circuits every 72 hours is not supported by research and is therefore being challenged. ⋯ Previous research studying the time interval between circuit changes is reviewed. Contributing factors such as the contamination of tubing by various means are discussed and finally research-based proposals for future practice will be made.
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Intensive Crit Care Nurs · Oct 1996
Review Case ReportsThe nurse's role in pain assessment and management in a coronary care unit.
Nurses play an important role in the assessment and management of pain, but some have many misbeliefs about the pain experience (Watt-Watson & Donovan 1992) and pain management, which may affect their judgment when dealing with a patient's pain. This review of literature on pain assessment and management includes pharmacological and nonpharmacological treatment. A case study highlights the nurse's role in assessment and management of pain in patients admitted to a coronary care unit. Recommendations are made as to how the nursing management of pain can be improved.