Enfermería intensiva
-
Adequate monitoring of analgesia and sedation should be one of the main goals in the Intensive Care Units. Once the analgesia is assured, the correct dosage of the sedatives will depend on the correct monitoring of the sedation level. ⋯ These scales are appropriate for the evaluation of mild sedation but they cannot correctly evaluate deeply sedated patients or those patients who require continuous intravenous administration of neuromuscular blockade agents. In this chapter, we review the most used monitor to control the adequate level of sedation in the Intensive Care Units as well as the BIS(R) Monitor, which is the one recommended by the Analgesia and Sedation Work Group of the Spanish Society of Critical Care Medicine (SEMICYUC).
-
This study aimed to verify the relationship between different Sedation Rating Scales (SRSs) for critical patients on mechanical ventilation and to know the relationship between the SRSs, clinical information and the dose of sedative and analgesia drugs (SAD). ⋯ The RAMSAY scale that has not been validated in ICU patients has a strong interrelation with the other already validated SRSs. SRSs are subjective and do not correlate with the clinical information and the SAD doses, probably due to the sample's small size and heterogeneity.
-
Noninvasive mechanical ventilation is one more step in the treatment of patients with acute respiratory failure. In addition to gas exchange disorders, its primary indication to initiate it is the presence of signs of respiratory muscles fatigue. ⋯ This sequence of events, which seem so logical, is almost never achieved in the clinical practice, commonly observing some asynchrony in ventilated patients. The presence of patient-ventilator asynchrony leads to increased breathing work, which would lead to the failure of the main objective of ventilatory support, that is none other than decline in the patient's respiratory work.
-
Enfermería intensiva · Apr 2009
[Evaluation of the effectiveness of an in-hospital cardiac alarm system].
⋯ CPR was performed in 90 patients. Average arrival time was 1 minute. Origin was non-cardiac 56%, cardiac 34.4%. Initial rhythm was non-shockable 76.7%, shockable 22.2%. Survival at hospital discharge: 20%. Cerebral Performance Category 1: 89%. Survival after one year 16.7%. Survival: cardiac etiology (P=0.05; OR 0.20; 95% CI 0.06-0.65). Initial rhythm shockable (P=0.0001; OR 0.18; 95% CI 0.05-0.56) CONCLUSIONS: Our CA system is effective. We achieve a survival and cerebral performance categories on hospital discharge that is similar to other studies although the rate of patients with shockable rhythm and cardiac etiology in our series is less than others published.
-
Enfermería intensiva · Jan 2009
[Evaluation of pain during posture change in patients with invasive mechanical ventilation].
The evaluation of pain poses special difficulties in critical patients who have altered verbal communication. ⋯ Observation of the patient's behavior during posture change and the physiological changes produced allows the professionals to objectify the pain in the critical patients who can verbal communication problems.