Abstract:
:The patient in septic shock who develops vascular insufficiency secondary to purpura fulminans is a challenge to the healthcare team. Initial management is directed toward reversing the disease process by administering antibiotics immediately and initiating life-support measures. Emergency measures include optimizing oxygenation and ventilation, reestablishing and/or maintaining circulation and end-organ perfusion and correcting electrolyte imbalances and coagulopathies. After the emergent life-saving needs of the patient have been addressed, attention may be directed toward saving extremities. Epidural sympathetic blockade proved to be successful as an essential adjunctive intervention in preserving the lower extremities of our patient. We encourage other healthcare providers to consider this treatment to help decrease the morbidity of vascular insufficiency secondary to meningococcal purpura fulminans.
journal_name
Crit Care Nursejournal_title
Critical care nurseauthors
Chiafery MC,Stephany RA,Holliday KJsubject
Has Abstractpub_date
1993-06-01 00:00:00pages
71-6issue
3eissn
0279-5442issn
1940-8250journal_volume
13pub_type
杂志文章abstract::Heart failure is a burdensome cardiovascular condition associated with high rates of morbidity and mortality. The 3-month period after hospitalization is a vulnerable phase in which patients are at high risk for mortality and rehospitalization. To reduce risk during this period, patients with heart failure and reduced...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2018669
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:Preparation of drug solutions used with electronic syringe infusion pumps plays a crucial role in the delivery of an accurate drug concentration. Is there a correlation between drug concentrations during syringe pump infusion and preparation protocols? METHOD:Norepinephrine, insulin, and sufentanil were prep...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2016756
更新日期:2016-08-01 00:00:00
abstract::Children admitted to the ICU with status asthmaticus require continuous nursing assessment of respiratory status and monitoring of the response to therapy. Nurses must be aware of the progression of respiratory distress and of the expected response to treatment and the side effects that can occur with each therapy. By...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Delirium is a common neuropsychiatric diagnosis in intensive care units and often leads to extended hospital stays and an increased rate of complications. Delirium can be classified as hypoactive, hyperactive, or mixed. Hyperactive delirium is often accompanied by agitation, which is a predictive factor for ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020697
更新日期:2020-04-01 00:00:00
abstract::The end of the formal unit orientation program is a stressful time of adjustment for nurses hired into critical care without previous critical care experience. Although most units offer reassurance that experienced colleagues will provide the needed guidance, consistent support may not be available for many reasons. D...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2015368
更新日期:2015-08-01 00:00:00
abstract::The insertion of Silastic sheeting provides an opportunity for improved survival of patients with severe abdominal trauma. This new treatment modality represents a challenge to nurses to expand their knowledge base. ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract::Hypoplastic left heart syndrome is a severe form of congenital heart disease that results in single-ventricle physiology. Although surgical palliation in infants with this syndrome is widely agreed on in practice, variation occurs in both surgical and medical management. Perinatal factors that affect preoperative mana...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2016461
更新日期:2016-02-01 00:00:00
abstract::Leadless pacemakers will most likely be the future of cardiac pacing. Leadless pacing employs a single-chamber system to pace only the right ventricle and is fully self-contained, which eliminates the need for leads. These systems, implanted by using a transcatheter sheath, are indicated for patients who need right ve...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2017453
更新日期:2017-04-01 00:00:00
abstract:CLINICAL RELEVANCE:Clostridioides (formerly Clostridium) difficile infection is among the most identified causes of health care-associated infections in US hospitals and remains a major public health problem. The incidence and severity of C difficile infection are high among critically ill patients. Treating critically...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2019841
更新日期:2019-10-01 00:00:00
abstract::Cardiac output and cardiac index values are traditionally used by critical care nurses as indicators of myocardial contractility. Due to the incidence of compensatory tachycardia in many critically ill patients, however, the value of LVSWI as an indicator of myocardial contractility is enhanced, because the formula fo...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract::The most common cause of death due to the H1N1 subtype of influenza A virus (swine flu) in the 2009 to 2010 epidemic was severe acute respiratory failure that persisted despite advanced mechanical ventilation strategies. Extracorporeal membrane oxygenation (ECMO) was used as a salvage therapy for patients refractory t...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2011186
更新日期:2011-10-01 00:00:00
abstract::As the field of surgery advances and the conservative use of banked blood transfusion increases the need for postoperative autotransfusion has increased. By using the CATR, the patient's demands for blood can be more adequately met without causing further complications for the patient. This article presents one method...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract::Clinical practice varies regarding the choice of agent to treat hypertensive emergencies. With the development of national guidelines, a standardized pharmacotherapeutic approach would be recommended on the basis of evidence in the published literature. Such an approach might decrease the variability among practitione...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2010664
更新日期:2010-10-01 00:00:00
abstract::Clostridia are organisms which, in the right environment, can cause a rapidly spreading, fulminant myonecrosis. Early diagnosis and a combined management program are clearly paramount to a successful outcome. Knowledge of this disease and ongoing meticulous assessment are the tools that a nurse must use when dealing w...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract::"Broken heart syndrome," or takotsubo cardiomyopathy, is a spontaneously reversible form of cardio-myopathy that is often induced by emotional or physical stress. Signs and symptoms include chest pain, dyspnea, electrocardiographic changes, and elevated levels of cardiac biomarkers. Patients often have signs and sympt...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2009451
更新日期:2009-02-01 00:00:00
abstract::A 9-member educational task force and a 4-member panel of experts was used to establish the validity of the PEDS-BKAT, which was modified from version 4 of the adult BKAT for critical care nursing. A sample of 105 pediatric ICU nurses from 6 settings took the PEDS-BKAT. Test results include a mean score of 78.9 points...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
abstract::Status epilepticus is a medical emergency that requires rapid diagnosis and treatment. Nonconvulsive status epilepticus is frequently underdiagnosed and therefore undertreated, which can lead to permanent neuronal damage resulting in disability or death. Despite the frequent occurrence and morbidity associated with st...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2016892
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The outbreak of coronavirus disease 2019 (COVID-19) rippled across the world from Wuhan, China, to the shores of the United States within a few months. Hospitals and intensive care units were suddenly faced with a "tsunami" warning requiring instantaneous implementation and escalation of disaster plans. EVI...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2020799
更新日期:2020-12-01 00:00:00
abstract::More patients in the intensive care unit are surviving their critical illnesses because of advances in medical care. This change in survival has led to an increased awareness of the emotional consequences of being critically ill. Posttraumatic stress disorder has been identified in approximately 9% to 27% of criticall...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2015758
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Hospital-acquired pressure ulcers are serious clinical complications that can lead to increased length of stay, pain, infection, and, potentially, death. The surgical progressive care unit at Sharp Grossmont Hospital, San Diego, California, developed the multidisciplinary Healthy Skin Project to decrease the...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2013290
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Immobility contributes to many adverse effects in critically ill patients. Early progressive mobility can mitigate these negative sequelae but is not widely implemented. Appreciative inquiry is a quality improvement method/change philosophy that builds on what works well in an organization. OBJECTIVES:To ex...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020251
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Pressure injuries, also known as pressure ulcers, are a serious complication of immobility. Patients should be thoroughly examined for pressure injuries when admitted to the intensive care unit to optimize treatment. Whether community-acquired pressure injuries correlate with poor hospital outcomes among cri...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2019530
更新日期:2019-06-01 00:00:00
abstract::IL-2 is a biotherapeutic drug and a biological response modifier. This drug has not been approved by the Food and Drug Administration for general use but continues to undergo clinical trials. Candidates for this therapy are patients with advanced carcinoma that has not responded to standard modalities of treatment. Ad...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::If no complications arise, the near-drowning victim is usually discharged within 48 hours. However, some patients require complex care because of multisystem failure. These patients challenge the critical care nurse, who must understand the interrelationships of the problems to provide quality care. The major focus of...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1993-08-01 00:00:00
abstract::Scientists are only beginning to fully understand the purpose of sleep and its underlying mechanisms. Lack of sleep is associated with many diseases, including infection, and with increased mortality. Lack of proper sleep is an important problem in the intensive care unit, and interventions have been designed to impro...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2012689
更新日期:2012-04-01 00:00:00
abstract::As surgery for complex congenital heart disease is becoming more advanced, an increasing number of patients are surviving into adulthood, yet many of these adult patients remain in the pediatric hospital system. Caring for adult patients is often a challenge for pediatric nurses, because the nurses have less experienc...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2016131
更新日期:2016-08-01 00:00:00
abstract::This article discusses congenital heart defects that are marginal candidates for biventricular repair and highlights the anatomic considerations upon which the surgical decision is based. Specifically, the article reviews the importance of capacitance and compliance of the ventricles and their associated atrioventricu...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2018679
更新日期:2018-10-01 00:00:00
abstract::This 6-month retrospective study provided our medical center with a profile of the population of patients readmitted within 31 days of discharge. We found that chronic illness and age greater than 65 years were the high risk factors related to patient readmissions. These 2 attributes are common in critical care patien...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::Staff nurse preceptors are integral members of effective critical care orientation programs. Much of the success of the orientation experience and orientee satisfaction depends on them. A critical care preceptor workshop containing a review of the orientation program and the application of educational principles in cr...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::In patients with chronic heart failure, fluid retention (or hypervolemia) is often the stimulus for acute decompensated heart failure that requires hospitalization. The pathophysiology of fluid retention is complex and involves both hemodynamic and clinical congestion. Signs and symptoms of both hemodynamic and clinic...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2012877
更新日期:2012-04-01 00:00:00