Dynamics (Pembroke, Ont.)
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Dynamics (Pembroke, Ont.) · Jan 2003
ReviewReview of laryngospasm and noncardiogenic pulmonary edema.
Laryngospasm is an emergency situation that requires rapid identification and resolution of the obstructed glottis. Although there is a low incidence of laryngospasm, it is important to remember that any patient has the potential for post-extubation laryngospasm. Nurses must know about the causes, risk factors and treatment for this respiratory emergency. ⋯ The triggers, signs and symptoms, and treatment of NCPE are also reviewed. Due to the risk of laryngospasm recurring or NCPE presenting itself, any patient who has had laryngospasm needs close monitoring for two to three hours after the laryngospasm has resolved. It is important for nurses to review the interventions for laryngospasm and NCPE prior to caring for a patient with this respiratory emergency.
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Dynamics (Pembroke, Ont.) · Jan 2003
ReviewIntra-abdominal pressure monitoring for critically ill patients.
Increased intra-abdominal pressure (IAP) is associated with a variety of clinical situations and has profound effects, both locally and systemically, that may result in organ dysfunction and failure. If not identified and treated promptly, increased IAP can be fatal. Urinary bladder pressure monitoring is a simple and reliable method of quantifying IAP and is a key factor leading to prompt management and a successful outcome for patients.
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Dynamics (Pembroke, Ont.) · Jan 2002
Review Case ReportsUnderstanding sepsis: from SIRS to septic shock.
Sepsis remains the leading cause of death in non-coronary ICU patients, despite improvements in supportive treatment modalities such as antimicrobial drugs and ventilation therapy. Further, the incidence of sepsis is projected to increase in years to come, related to factors including a rise in immunosuppressed patient populations and more widespread use of invasive lines and procedures. ⋯ The role of the critical care nurse is an important aspect of the care of these patients. Early identification of patients at risk for, or who are developing, sepsis is crucial in order to improve patient outcomes.
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Emergency treatment measures in the setting of a cardiopulmonary arrest have recently been reclassified according to the strength of evidence in support of their use. As a result, there are new recommendations that must be incorporated, both in the management of patients in cardiac arrest and those with clinical findings that have the potential to deteriorate and become life-threatening. This article provides an overview of the 2000 ACLS guidelines, with particular emphasis on new developments in the management of patients with acute coronary syndromes, changes in the tachycardia algorithms, and recommendations pertaining to endotracheal intubation.
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Dynamics (Pembroke, Ont.) · Jan 2002
ReviewAprotinin: antifibrinolytic and anti-inflammatory mechanisms of action in cardiac surgery with cardiopulmonary bypass.
Cardiopulmonary bypass results in activation of the coagulation, fibrinolytic, inflammatory, and complement cascades. These activated cascades result in a decrease in the number of circulating coagulation factors, hyperfibrinolysis, thrombocytopenia, platelet defects, coagulopathies, and an acute inflammatory response. ⋯ The pathophysiological consequences of cellular activation associated with cardiopulmonary bypass, basic mechanisms of action of aprotinin, pharmacodynamic and pharmacokinetic properties, dosing, adverse reactions, and cost/benefit ratio are discussed in this article. Critical care nurses need to know about aprotinin to understand its role in reducing blood loss and transfusions during and after cardiac surgery.