American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Association of Injury Factors, Not Body Mass Index, With Hospital Resource Usage in Trauma Patients.
Allocating resources appropriately requires knowing whether obese patients use more resources during a hospital stay than nonobese patients. ⋯ Associations between body mass index and outcomes have been noted when assessed as independent variables. However, when resource usage was assessed as a multifaceted outcome variable, injury factors (higher Injury Severity Score, lower scores on the Glasgow Coma Scale, more physiological complications) were associated with resource usage (increased length of stay in the intensive care unit and increased number of procedures). These findings provide clinicians a new perspective for evaluating the complex relationship between patient/injury characteristics and hospital resource usage.
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Randomized Controlled Trial
Family Presence During Resuscitation: Impact of Online Learning on Nurses' Perception and Self-confidence.
Family presence during resuscitation (FPDR) is supported by patients and their family members. Nurses, however, including critical care nurses who frequently implement resuscitative care, have mixed views. ⋯ Online learning is a feasible and effective method for educating large numbers of critical care nurses about FPDR. Online learning can improve perceptions and self-confidence related to FPDR, which may promote more widespread adoption of FPDR into practice.
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Observational Study
Clinical Outcomes of Inadequate Calorie Delivery and Protein Deficit in Surgical Intensive Care Patients.
Adequate nutritional therapy in critically ill patients is integral to optimal outcome. ⋯ Cumulative macronutrient deficits have important clinical outcomes in surgical intensive care patients.
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Case Reports
A Fatal Case of Eczema Herpeticum With Septic Shock Due to Methicillin-Resistant Staphylococcus aureus.
A 62-year-old woman treated with several courses of corticosteroids for an undifferentiated rash came to the emergency department with progressively worsening cutaneous signs and symptoms and generalized weakness. She had scabies, and despite treatment continued to decompensate. ⋯ This case illustrates the complications of the rare entity eczema herpeticum, which occurs most often in immunocompromised patients and is associated with a high mortality. Maintaining a high index of suspicion for this disease in decompensating patients with an unidentified rash is essential to avoid catastrophic outcomes.