American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study
Reliability of an intravenous intermittent access port (saline lock) for obtaining blood samples for coagulation studies.
Patients admitted to rule out myocardial infarction often receive a heparin infusion that requires measurement of partial thromboplastin time every 6 to 8 hours until coagulation values stabilize. If the patient's acuity at admission does not necessitate placement of arterial or central catheters, insertion of an intermittent intravenous access port (saline lock) would decrease the need for frequent venipuncture. Many studies on obtaining blood samples via arterial and central catheters have been reported, but no reports have described the method of using a saline lock or the amount of blood discarded during that procedure. ⋯ The untoward effects of frequent venipunctures to obtain blood samples for measurement of prothrombin and partial thromboplastin times can be lessened by using an 18-gauge saline lock to obtain blood samples and discarding the first 0.5 mL of blood withdrawn before the samples for coagulation studies are collected.
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Clinical Trial Controlled Clinical Trial
Instillation of normal saline during endotracheal suctioning: effects on mixed venous oxygen saturation.
Instillation of normal saline before endotracheal suctioning is thought to facilitate removal of secretions and ultimately to improve the patient's oxygenation status. To date, no studies have used an in vivo measure of oxygenation such as mixed venous oxygen saturation to characterize the effects of instillation of normal saline. ⋯ Instillation of normal saline before endotracheal suctioning has an adverse effect on oxygenation as indicated by mixed venous oxygen saturation. This finding contradicts the assumption that instillation of normal saline improves oxygenation status.
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Randomized Controlled Trial Clinical Trial
Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction.
Acute myocardial infarction places additional demands on an already compromised myocardium. Relaxing music can induce a relaxation response, thereby reversing the deleterious effects of the stress response. ⋯ Patients recovering from acute myocardial infarction may benefit from music therapy in a quiet, restful environment.
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Critically ill patients are at high risk for pressure ulcers. ⋯ Patients in intensive care units have an increased risk for pressure ulcers. Although waiting until 12 hours after a patient's admission to the intensive care unit to obtain the initial Braden rating may be reasonable (with the second rating obtained 36 hours after admission), additional research is needed before this practice can be recommended.