American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Physical restraints are more likely to be used in critical care units than in other hospital units because use of invasive procedures and mechanical ventilation is more common in critical care units. Initiation and maintenance of physical restraint devices is largely a nursing responsibility. Previous clinical experience is a variable often suggested to be related to intensive care nurses' use of physical restraints. ⋯ The reported lack of content addressing use of physical restraints in today's nursing curricula is a concern, as physical restraints are commonly used in critical care units.
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PubMed/MEDLINE (1966-November 2014) was searched to identify relevant published studies on the overall frequency, types, and examples of medication errors during medical emergencies involving cardiopulmonary resuscitation and related situations, and the breakdown by type of error. The overall frequency of medication errors during medical emergencies, specifically situations related to resuscitation, is highly variable. ⋯ Because of the chaos of the resuscitation environment, errors in prescribing, dosing, preparing, labeling, and administering drugs are prone to occur. System-based strategies, such as infusion pump policies and code cart management, as well as personal strategies exist to minimize medication errors during emergency situations.
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Comparative Study Observational Study
Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures.
To compare the utility of a multiplex polymerase chain reaction system (SeptiFast) and blood cultures for detecting bacteria and fungi in blood samples from patients with severe sepsis or septic shock. ⋯ The SeptiFast test provided quicker microbiological diagnosis and identified significantly more microorganisms than blood cultures did, particularly when samples were collected after antibiotic therapy had started or infections were due to resistant bacteria and yeast.
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Critical illness comprises a heterogeneous group of serious medical conditions that typically involve an initial proinflammatory process. A compensatory anti-inflammatory response may occur that, if severe and persistent, places the patient at high risk for adverse outcomes including secondary infection and death. ⋯ Intriguing data suggest that critical illness-induced immune suppression may be reversible with agents such as interferon-γ, granulocyte macrophage colony-stimulating factor, interleukin 7, or anti-programmed death-1 therapy. Future approaches for characterization of patient-specific immune derangements and individualized treatment could revolutionize how we recognize and prevent complications in critically ill patients.