Review and update of neuromuscular blocking agents

1989 ◽  
Vol 9 (10) ◽  
pp. 76-80 ◽  
Author(s):  
DD O'Brien
Keyword(s):  
Critical Care ◽  
Nursing Care ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Anesthesia Care ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Blocking Agents

The patient arriving in the PACU or ICU following surgery requires vigilant and intelligent nursing care. The postanesthesia nurse or critical care nurse with an understanding of the neuromuscular blocking agents used in anesthesia care is best prepared to observe, evaluate, and care for this patient.

A national survey of critical care nurses' practices related to administration of neuromuscular blocking agents

2001 ◽  
Vol 10 (3) ◽  
pp. 139-145 ◽  
Author(s):  
JG Foster ◽  
SK Kish ◽  
CH Keenan
Keyword(s):  
Critical Care ◽  
Peripheral Nerve ◽  
The United States ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Critical Care Nurses ◽  
Blocking Agents ◽  
Care Facilities ◽  
Acute Care Facilities

BACKGROUND: Recommendations on use of neuromuscular blocking agents include using peripheral nerve stimulators to monitor depth of blockade and concomitantly administering sedatives and/or analgesics. OBJECTIVE: To evaluate critical care nurses' practices in administering neuromuscular blocking agents. METHODS: A 16-item survey was mailed to 483 acute care facilities in the United States. Of these, 246 surveys (51%) were returned and analyzed to determine use of neuromuscular blocking agents, peripheral nerve stimulators, sedatives, and analgesics. Logistic regression analysis was used to find independent predictors of use of peripheral nerve stimulators. RESULTS: Seventy-five percent of respondents reported long-term use of neuromuscular blocking agents in critically ill patients. Of those, 63% monitored the level of blockade with peripheral nerve stimulators. Reasons for not using peripheral nerve stimulators included unavailability of equipment (48%), lack of training (36%), and insufficient evidence that peripheral nerve stimulators improve care (23%). Predictors of use of stimulators were facilities with more than 150 beds (P < .001) and administration of neuromuscular blocking agents by continuous infusion (P < .001). Ninety-five percent of respondents reported using concurrent analgesics/sedatives always or most of the time. Facilities with fewer than 10 beds in the intensive care unit used concurrent analgesics/sedatives significantly less often than did facilities with 10 beds or more (90% vs 98%, respectively; P = .03). CONCLUSIONS: Small and large facilities differ in concomitant use of analgesics/sedatives and peripheral nerve stimulators. Education and research are needed to ensure that patients receive adequate monitoring and sedation during administration of neuromuscular blocking agents.

Caring for the victim of near drowning

1993 ◽  
Vol 13 (4) ◽  
pp. 25-32 ◽  
Author(s):  
DM Glankler
Keyword(s):  
Critical Care ◽  
Nursing Care ◽  
Quality Care ◽  
Complex Care ◽  
Major Focus ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Near Drowning ◽  
Provide Quality Care

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 care is stabilization and normalization of the cardiovascular, respiratory and neurologic systems through accurate nursing assessments and implementation of appropriate nursing care.

Clinical management of DIC: early nursing interventions

1991 ◽  
Vol 11 (10) ◽  
pp. 42-53 ◽  
Author(s):  
C Epstein ◽  
A Bakanauskas
Keyword(s):  
Critical Care ◽  
Nursing Care ◽  
Clinical Manifestations ◽  
Nursing Interventions ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Quality Patient Care ◽  
Comprehensive Knowledge ◽  
Assessment Skills ◽  
Primary Nurse

Achievement of successful patient outcomes depends on the availability of a primary nurse responsible for all aspects of nursing care. A consistent caregiver not only has a grasp of phenomena at hand but possesses an overall perspective of recovery. Care can be evaluated and readjusted on a timely basis. Identification of signs of progress as well as deterioration may be facilitated through continuity of care. The primary nurse can provide meaningful, ongoing information to the patient and significant others as a means of optimizing their coping behaviors. Effective nursing care of the patient with DIC is enhanced by a thorough understanding of its pathophysiology and its clinical manifestations. When the critical care nurse has a comprehensive knowledge base and uses purposeful assessment skills, potential complications become much clearer and are avoided. The primary nurse who knows how to prioritize care is capable of anticipating the patient's needs. By integrating theory with practice, the critical care nurse functions from a position of strength in promoting quality patient care.

Laser angioplasty in peripheral vascular disease

1990 ◽  
Vol 10 (5) ◽  
pp. 65-78
Author(s):  
MC Paul ◽  
M Halfman-Franey
Keyword(s):  
Critical Care ◽  
Nursing Care ◽  
Patient Population ◽  
Surgical Intervention ◽  
Laser Energy ◽  
Laser Angioplasty ◽  
Peripheral Vascular ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Peripheral Arterial

The use of laser energy to recanalize peripheral arterial vessels is a new and challenging alternative to more extensive surgical intervention. This exciting technique allows the critical care nurse to respond creatively to changing protocols and patient situations, establishing standards of nursing care for this patient population.

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