Compatibility of Intravenous Drugs in a Coronary Intensive Care Unit

1986 ◽  
Vol 20 (5) ◽  
pp. 349-352 ◽  
Author(s):  
Joseph F. Dasta ◽  
Frederick P. Zeller ◽  
Robert J. Anders
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Care Setting ◽  
Setting Time ◽  
Critical Care Setting ◽  
Critically Ill Patient ◽  
Accessible Information ◽  
The Stability ◽  
Physical And Chemical

In a coronary intensive care unit (CCU) it is often necessary to utilize extensive pharmacologic interventions and multiple intravenous medications in order to stabilize a critically ill patient. However, the necessity of several intravenous infusions often presents the problem of compatibility of these medications when infused within a common line. The pharmacist must possess adequate skill to identify potential incompatibilities by retrieving information on the physical and chemical compatibilities of various intravenous medications. In a critical care setting, time is an important factor, and information that can be obtained rapidly and reliably is vital for the pharmacist to prevent the administration of an irritating substance or a medication that has undergone deterioration as a result of chemical inactivation. A compatibility table containing the most commonly used drugs in a CCU has been developed based on currently available literature, including standard reference texts, about these medications. The table outlines the potential for interactions, within a single intravenous line, when several drugs are infused concurrently. In addition, a review of the concepts of physical and chemical incompatibility is presented. The stability of an admixture is defined utilizing requirements established in the USP NF monographs and manufacturers' specifications. The resulting table concisely organizes vital information in a form that allows rapid, accessible information to the pharmacist in a critical care setting, where it is most needed.

Valvular stenosis

2020 ◽  
pp. 195-206
Author(s):  
Ana Martinez-Naharro ◽  
Susanna Price
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Care Setting ◽  
Multimodality Imaging ◽  
Clinical Status ◽  
Critical Care Setting ◽  
Critically Ill Patient ◽  
Valvular Stenosis ◽  
Echocardiographic Parameters

Evaluation of valve stenosis in the critical care setting can be challenging, as the clinical status of the patient may preclude the gold standard for assessment (multimodality imaging), demanding reliance on echocardiographic parameters that are not well-validated in the intensive care unit. Valve stenosis is common, and where it precipitates intensive care admission is likely to be severe, and affecting the left-sided valves. On occasion, however, stenosis may be an incidental finding in a critically ill patient with a variable impact on their clinical status. Right-sided lesions are rare (outside the grown-up congenital patient population) and only very infrequently lead to acute haemodynamic deterioration. Echocardiography is indicated in any intensive care unit (ICU) patient where there is suspicion of valvular heart disease. This chapter outlines how to assess valvular stenosis and define its severity in the critical care setting according to integrated echocardiographic parameters. It highlights how critical care pathophysiology may complicate this evaluation, and any potential pitfalls that may exist.

Elderly Patients in Critical Care: An Overview

1992 ◽  
Vol 3 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Mickey Stanley
Keyword(s):  
Older Adults ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Elderly Patients ◽  
Nursing Care ◽  
Care Setting ◽  
Critical Care Setting ◽  
Care Planning ◽  
Care Needs

Elderly patients who enter the critical care setting have special nursing care needs based on the physiologic changes of aging. An overview of the changes of aging associated with the immunologic, cardiovascular, integumentary, musculoskeletal, and renal systems provides the basis for care planning to meet the needs of older adults in the intensive care unit

Anticonvulsants: Pharmacotberapeutic Issues in the Critically Ill Patient

1991 ◽  
Vol 2 (4) ◽  
pp. 639-656 ◽  
Author(s):  
Robert E. Dupuis ◽  
Jorge Miranda-Massari
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Critical Care Setting ◽  
Critically Ill Patient ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Epilepsy Treatment

Critically ill patients often have or develop conditions that make them susceptible to seizures and epilepsy. Treatment frequently involves the use of anticonvulsants. In order to use these effectively, the critical care nurse must be aware of the indications and controversies surrounding their use, the pathophysiologic conditions that impact on the disposition, and appropriate dosing and monitoring of these agents in the critical care setting

The Meaning of Our Work

2011 ◽  
Vol 22 (4) ◽  
pp. 397-407
Author(s):  
Clareen A. Wiencek ◽  
Betty R. Ferrell ◽  
Molly Jackson
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Moral Distress ◽  
Survival Rates ◽  
Critically Ill Patient ◽  
Current Profile ◽  
Patients With Cancer ◽  
A Current

The prevalence and survival rates of critically ill patients with cancer in the intensive care unit have increased considerably in the past 2 decades; yet, the meaning of caring for cancer patients in this setting may fall along a continuum. This article addresses the nurse’s experience in caring for the critically ill patient with cancer by presenting a current profile of these patient in the intensive care unit in the context of the historical development and mission of critical care and the evolution of cancer as a chronic disease. The moral distress that can result when these 2 “cultures” or “realities” collide and the meaning of the nurse’s work will be examined. Strategies and resources for critical care nurses to incorporate into their practice when caring for the critically ill patient with cancer, and themselves, will be addressed.

The Dying Patient in the Critical Care Setting: Making the Critical Difference

1990 ◽  
Vol 1 (1) ◽  
pp. 178-186 ◽  
Author(s):  
Deborah Caswell ◽  
Anna Omery
Keyword(s):  
Critical Care ◽  
Health Care Providers ◽  
Care Setting ◽  
Critical Care Setting ◽  
Critically Ill Patient ◽  
Care Providers ◽  
Critical Difference ◽  
Nursing Diagnosis ◽  
Care Situation ◽  
Dying Patient

Death is an inevitable fact in the critical care setting. This fact does not make it more comfortable for the nurse who is caring for a critically ill patient who is dying. Some health care providers have recommended that the critical care resources are better utilized for the patient whose prognosis is not death. This position can be countered with the perspective that there may be no better place to provide the intensive nursing care that the dying patient may need than the critical care setting. A new nursing diagnosis, Terminal Syndrome related to the dying process is introduced to assist the nurse in providing comprehensive care for what is often a complex patient care situation. The goal is to achieve for each dying individual in the critical care setting what she or he truly desires, an end to the life process, a death achieved with comfort and dignity.

scholarly journals Rapid Ultrasound Methods in Anesthesiology and Critical Care Medicine

2015 ◽  
Vol 25 (2) ◽  
pp. 94-102
Author(s):  
Andrius Macas ◽  
Asta Mačiulienė ◽  
Sandra Ramanavičiūtė ◽  
Alina Vilkė ◽  
Kęstutis Petniūnas ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Critical Care ◽  
Intensive Care ◽  
Trauma Patient ◽  
Standard Of Care ◽  
Intensive Care Unit Setting ◽  
Critically Ill Patient ◽  
Essential Information ◽  
Ultrasound Applications

The variety of focus assessed ultrasound applications and protocols in emergency department and intensive care unit setting is growing. Focus assessed protocols can provide essential information about critically ill patient. It is now the standard of care to perform focused assessment using sonography for trauma - FAST early in the evaluation of trauma patient. Other focus assessed protocols can prove to be useful as well as FAST.

Liaison Psychiatry: A Role on the Medical Intensive Care Unit

1982 ◽  
Vol 11 (4) ◽  
pp. 379-386 ◽  
Author(s):  
Nathan Billig
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Care Setting ◽  
Medical Intensive Care Unit ◽  
Holistic Approach ◽  
Separate Entity ◽  
Liaison Psychiatry ◽  
Case Conferences ◽  
Medical Intensive Care

A psychiatric liaison program on a medical intensive care unit is described. The principle elements of the program include the psychiatrist becoming a member of the MICU “team” via: 1) attendance at morning medical rounds; 2) conducting case conferences; 3) availability to the nursing staff as a separate entity; 4) consulting with the unit directors; and 5) supervising a resident in psychiatry in his consultative work on the unit. The liaison psychiatrist's presence on the team facilitates an holistic approach to the patient and deals with intra-staff and patient-staff reactions in the critical care setting.

scholarly journals Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort

2021 ◽  
Author(s):  
Marie-Madlen Jeitziner ◽  
André Moser ◽  
Pedro D Wendel-Garcia ◽  
Matthias Thomas Exl ◽  
Stefanie Keiser ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patient ◽  
Icu Mortality ◽  
Swiss Health ◽  
Increased Risk ◽  
Staffing Ratio ◽  
Secondary Study

Abstract Background The modifications to the standard intensive care unit (ICU) organization that had to be urgently implemented worldwide to overcome the surge of ICU admissions due to patients with a severe coronavirus disease 2019 (COVID-19) have resulted in increased workload and patients-to-nurse ratio. The aim of this study was to investigate whether level of critical care staffing could be associated with an increased risk of ICU mortality (primary endpoint), length of stay, mechanical ventilation and the evolution of disease (secondary study endpoints) in critically ill patients with COVID-19. Methods Retrospective multicenter analysis of the international Risk Stratification in COVID-19 patients in the Intensive Care Unit (RISC-19-ICU) registry that prospectively enrolls patients developing critical illness due to COVID-19 in several countries worldwide. The analysis was limited to the period between March 1st, 2020 and May 31st, 2020, to ICUs in Switzerland that have collected additional data on nurse and physician staffing. Hierarchical regression models were used to investigate crude and adjusted effects of critical care staffing ratio on study endpoints. We adjusted for diseases severity and weekly caseload. Results Among the 38 Swiss participating ICUs, 17 recorded critical care staffing information. The study population included 437 patients and 2342 daily assessments of patient-to-nurse/physician ratio. Median of daily patient-to-nurse ratio started at 1.0 ([IQR] 0.5–1.5; calendar week 9) and peaked at 2.4 (IQR 0.4-2.0; calendar week 16), while the median of daily patient-to-physician ratio started at 4.0 (IQR 2.1-5.0; calendar week 9) and peaked at 6.8 (IQR 6.3–7.3; calendar week 19). Neither the patient-to-nurse ratio [adjusted Odds Ratio (OR) 1.28, 95% confidence interval (CI) 0.85–1.94; doubling of ratio] nor the patient-to-physician ratio [adjusted OR 1.08, 95% CI 0.87–1.32; doubling of ratio] was associated with ICU mortality. We found no association of critical care staffing on the investigated secondary study endpoints in adjusted models. COnclusion The Swiss health care system successfully overcame the first wave of the COVID-19 pandemic with regards to the unprecedented demand for ICU treatments. The reduced availability of critical care staffing resources per critically ill patient in Swiss ICUs did not translate in an overall increased risk of mortality.

scholarly journals Sleep and Delirium in Pediatric Critical Illness: What Is the Relationship?

2018 ◽  
Vol 6 (4) ◽  
pp. 90 ◽  
Author(s):  
Amy Calandriello ◽  
Joanna Tylka ◽  
Pallavi Patwari
Keyword(s):  
Risk Factors ◽  
Critical Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Care Setting ◽  
Pediatric Intensive Care ◽  
Critical Care Setting ◽  
Pediatric Critical Care ◽  
Disturbed Sleep ◽  
Potential Risk Factors

With growing recognition of pediatric delirium in pediatric critical illness there has also been increased investigation into improving recognition and determining potential risk factors. Disturbed sleep has been assumed to be one of the key risk factors leading to delirium and is commonplace in the pediatric critical care setting as the nature of intensive care requires frequent and invasive monitoring and interventions. However, this relationship between sleep and delirium in pediatric critical illness has not been definitively established and may, instead, reflect significant overlap in risk factors and consequences of underlying neurologic dysfunction. We aim to review the existing tools for evaluation of sleep and delirium in the pediatric critical care setting and review findings from recent investigations with application of these measures in the pediatric intensive care unit.

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