Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Dec 2002
ReviewTension pneumothorax: a pulmonary complication secondary to regional anesthesia from brachial plexus interscalene nerve block.
Interscalene brachial plexus anesthesia is often used for surgeries involving the shoulder and upper arm. This method of regional anesthesia decreases pain, nausea, and vomiting associated with general anesthesia. ⋯ Recognition of early signs and symptoms of tension pneumothorax and expeditious treatment for rapid decompression before physiologic decompensation is mandatory. This article discusses the interscalene brachial plexus block procedure leading to the pathogenesis, clinical presentation, diagnosis, and treatment of tension pneumothorax.
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Compartment syndrome is classically considered a complication of a musculoskeletal injury. Recent research has confirmed the abdomen as a potential compartment with the capability to cause life-threatening local and systemic manifestations. Abdominal compartment syndrome (ACS) is precipitated by an acute increase in abdominal contents volume with resulting intraabdominal hypertension. ⋯ Patients at risk for ACS include trauma (blunt or open), retroperitoneal hemorrhage, massive fluid resuscitation, pancreatitis, pneumoperitoneum, and neoplasm. Surgical decompression is the treatment of choice. The perianesthesia nurse plays a critical role in the team managing a patient at risk for abdominal compartment syndrome through intraabdominal pressure monitoring, wound care, and end organ perfusion support.
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J. Perianesth. Nurs. · Dec 2002
ReviewAllergic reactions to drugs: implications for perioperative care.
Clinically, one must be able to differentiate between an allergic reaction and an adverse reaction. Clinical manifestations of allergic reactions range from urticaria and rash to bronchoconstriction, laryngeal edema, hematologic disorders, and other serious reactions. Many drugs administered in the perioperative setting can cause allergic reactions. ⋯ Although true allergic reactions to opioids are rare, naturally occurring compounds like morphine and codeine can cause allergic reactions. After stopping the offending drug, mild allergic reactions can be managed with diphenhydramine, with or without a steroid. Significant allergic reactions require more aggressive management with oxygen, intravenous fluids, epinephrine, and histamine blockers.
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J. Perianesth. Nurs. · Aug 2002
Case ReportsComplex Regional Pain Syndrome in the ambulatory surgical care setting.
This article provides an historical synopsis from the 17th century to the present regarding the disease process known as Complex Regional Pain Syndrome (CRPS) Type I. An overview of the disease symptoms, plausible theories, and a review of the pain cycle, relief measures, and a case scenario are reported. The focus of pain blockade was chosen because this was the intervention used in this particular case. The author presents the holistic standpoint of the importance of incorporating complementary alternative medical practices (CAMP) to enhance a positive outcome for this client. ⋯ -Based on the content of this article, the reader should be able to (1) distinguish the main characteristic between CRPS Type I (reflex sympathetic dystrophy) and CRPS Type II (causalgia); (2) identify symptoms related to CRPS Type I; and (3) identify the stages of CRPS and state potential interventions used in the treatment of CRPS Type I.