American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Understanding the challenges faced by family members involved in decisions about the use of life-sustaining treatment for incompetent patients in the ICU is necessary for developing empirically based supportive interventions. ⋯ Family members of patients in the ICU are willing and able to take responsibility for decisions about the use of life-sustaining treatment for their loved ones. The long-term acceptance of the experience and the decisions made depends greatly on the interactions between the family member who makes the decision and nurses and physicians in the clinical setting.
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Outcomes management that uses critical pathways may decrease costs while improving outcomes for patients who require prolonged mechanical ventilation. ⋯ Outcomes-managed care did not have a significant effect on duration of ventilation, length of stay in the hospital, or outcome in patients receiving long-term mechanical ventilation.
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Comparative Study
Hemodynamic monitoring: a comparison of research and practice.
Measurement of hemodynamic parameters is a common practice and is well researched, but little information is available on the translation of the research into actual practice. ⋯ Research findings are generally being implemented at the bedside, although not completely or consistently. Minimizing the barriers to use of research is within the scope of nurses' practice.
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Radiofrequency catheter ablation is a technique for curing cardiac arrhythmias by destroying tissue that is a critical part of the targeted electrical circuit. Nausea and vomiting have been observed after use of this technique, but no study to date has examined these complications. ⋯ Nausea and vomiting occurred in a considerable number of cases. Female sex, younger age, and longer procedure duration increased the risk of nausea, whereas only age and procedure duration were associated with vomiting. This study may guide clinicians to use a prophylactic antiemetic in patients undergoing radiofrequency catheter ablation, especially patients at increased risk for nausea and vomiting.
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Malignant hyperthermia is a pharmacogenetic disease of skeletal muscle characterized by hypermetabolism that occurs on exposure to a triggering agent or agents. The most common agents are halogenated inhalational anesthetics and succinylcholine, a depolarizing muscle relaxant. ⋯ A thorough preoperative interview should be done to determine risk factors and susceptible patients. This article provides critical care nurses with sound information on the pathophysiology of malignant hyperthermia, the ability to assess the disease properly and treat the patient both before and after the crisis, and the ability to provide support and teaching to patients and patients' families to prevent the recurrence of malignant hyperthermia.