Journal of trauma nursing : the official journal of the Society of Trauma Nurses
-
Hemorrhagic shock is a severe life-threatening emergency affecting all organ systems of the body by depriving tissue of sufficient oxygen and nutrients by decreasing cardiac output. This article is a short review of the different types of shock, followed by information specifically referring to hemorrhagic shock. ⋯ Similarly, the classes of hemorrhagic shock are grouped by signs and symptoms, amount of blood loss, and the type of fluid replacement. This updated review is helpful to trauma nurses in understanding the various clinical aspects of shock and the current recommendations for fluid resuscitation therapy following hemorrhagic shock.
-
Trauma has been perceived by the public as occurring as an isolated event, always resulting in favorable outcomes. There has therefore been a lack of discussion of futility of care and termination of care when dealing with the sick trauma patient. Several stages exist where issues of futility and early termination of care must be considered. ⋯ Next is in the emergency room, where heroic measures may not benefit the very sick patient. In the operating room, the surgeon must always reassess and recognize when massive resuscitation will not benefit a particular trauma patient. Lastly, the intensivist must recognize those patients who may or may not benefit from continued efforts to sustain life.
-
The development of trauma systems in Australia has evolved over the last 18 to 20 years. Following a primarily North American model, nearly all the states and territories have identified and or implemented trauma system components to improve outcomes from injury. ⋯ As with most countries, multiple factors have influenced the development of trauma systems within each region. This study will provide an overview of the Australian Health System, initiatives implemented to reduce injury, the spectrum of trauma in Australia, and the current status of trauma systems development.
-
Penetrating neck injuries are uncommon in children, and when they do occur, they can be a challenge to manage. Injuries can be cardiovascular, aerodigestive, and neurovascular. In the past, injuries were explored surgically to evaluate the extent of the injury; studies are now showing that observation and less invasive studies have a positive outcome for the patient. Immediate surgical intervention remains mandatory for the clinically unstable patient, whereas stable patients have studies done that pertain to their signs and symptoms, thus having a conservative nonoperative approach to care.
-
It is traditionally assumed that licensure of healthcare professionals means that they are minimally competent. Many nursing specialty organizations offer examinations and other processes for certification, suggesting that certification is associated with continued competency. ⋯ A portfolio is a portable mechanism for evaluating competencies that may otherwise be difficult to assess. This article summarizes some of the literature addressing portfolios, including aspects of portfolio development process, the value of portfolios versus continuing education for competency assessment, evidence associated with portfolio usage, and suggestions for organizing nursing portfolios.