Diagnosis of chronic post-hypoxic myoclonus in near hanging survivor: Case report

2020 ◽  
Vol 32 (1) ◽  
pp. 5-8
Author(s):  
David Hersey
Keyword(s):  
Critical Care ◽  
Case Report ◽  
Cognitive Function ◽  
Attempted Suicide ◽  
Late Onset ◽  
Respiratory Arrest ◽  
Critical Care Nurses ◽  
Impaired Cognitive Function ◽  
Rare Syndrome

A 39-year-old male, who attempted suicide by hanging, developed chronic myoclonus with intact cognitive function. Chronic post-hypoxic myoclonus is a rare syndrome that may develop after a respiratory arrest and it presents as late onset and persistent purposeful myoclonus with preserved or slightly impaired cognitive function. Increasing critical care nurses’ awareness of chronic post-hypoxic myoclonus will lead to earlier diagnosis of this rare syndrome.

Thrombotic thrombocytopenic purpura: pathophysiology, treatment, and related nursing care

1995 ◽  
Vol 15 (6) ◽  
pp. 44-52
Author(s):  
M Kajs-Wyllie
Keyword(s):  
Critical Care ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Nursing Care ◽  
Critical Care Unit ◽  
Family Members ◽  
Vital Role ◽  
Critical Care Nurses ◽  
Thrombocytopenic Purpura ◽  
Rare Syndrome ◽  
Life Threatening

The patient diagnosed with TTP presents to the critical care unit with myriad life-threatening problems. Knowledge of the pathophysiology and treatment of this rare syndrome is essential to plan care appropriately. However, despite immediate diagnosis and intervention, the outcome may not be successful. Critical care nurses play a vital role in caring for these patients, as well as helping family members deal with this devastating disease.

AACN Synergy Model’s Characteristics of Patients: Psychometric Analyses in a Tertiary Care Health System

2007 ◽  
Vol 16 (2) ◽  
pp. 158-167 ◽  
Author(s):  
Barbara B. Brewer ◽  
Anne W. Wojner-Alexandrov ◽  
Nora Triola ◽  
Christine Pacini ◽  
Melanie Cline ◽  
...  
Keyword(s):  
Critical Care ◽  
Case Report ◽  
Construct Validity ◽  
Patient Care ◽  
Internal Consistency ◽  
Internal Consistency Reliability ◽  
Critical Care Nurses ◽  
Case Report Form ◽  
Second Phase ◽  
Interaction Factor

• Background Models for delivery of patient care that recognize the relationship between the characteristics of the patient and the competencies of the nurse are essential for high-quality outcomes.• Objectives (1) To test application of a case report form used to assess patients’ characteristics as defined by the American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care in a general population of pediatric and adult patients and (2) to evaluate the internal consistency reliability and construct validity of the patient characteristics measure found on the American Association of Critical-Care Nurses Web site.• Methods A cross-sectional correlational study was conducted in 2 phases. The first phase consisted of secondary data analysis of 481 ratings of patients provided by 11 expert nurses. The second phase consisted of primary data collection of 279 ratings of patients provided by 116 general and critical care nurses. The case report form was used to rate characteristics of patients in both phases; a self-rated nursing proficiency scale was used in the second phase. Descriptive statistics were used to describe the sample. Correlational techniques were used to evaluate internal consistency reliability and evidence of construct validity.• Results The case report form based on the AACN Synergy Model’s characteristics of patients showed satisfactory internal consistency reliability and evidence of discriminant construct validity. Exploratory factor analysis resulted in a 2-factor solution representing an intrapersonal interaction factor and an interpersonal interaction factor.• Conclusion The case report form for assessing characteristics of patients showed utility in a general population of adult and pediatric patients, some critically ill and some not. Nurses without previous knowledge of the AACN Synergy Model were able to apply the model during routine patient care.

Nursing Management of a Patient With COVID-19 Receiving ECMO: A Case Report

2021 ◽  
pp. e1-e10
Author(s):  
Nestor Neil A. Peig ◽  
Erica Djen ◽  
Marielle Garalza ◽  
Caroline Given ◽  
Jasmine Henderson ◽  
...  
Keyword(s):  
Critical Care ◽  
Acute Respiratory Distress Syndrome ◽  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Critical Care Nurses ◽  
Nursing Management ◽  
Membrane Oxygenation ◽  
Venovenous Extracorporeal Membrane Oxygenation

Introduction Venovenous extracorporeal membrane oxygenation has been recommended as an effective rescue therapy for select critically ill patients with COVID-19. This case report describes a first experience caring for a patient with COVID-19 who received venovenous extracorporeal membrane oxygenation and expands the literature by discussing relevant nursing management and operational considerations. Clinical Findings A 46-year-old man presented to a hospital emergency department with pleuritic chest pain, dyspnea, anorexia, and chills. The patient was intubated for pneumonia-associated acute respiratory distress syndrome. Diagnosis A nasopharyngeal swab specimen was positive for SARS-CoV-2, and chest radiography confirmed a diagnosis of COVID-19 with acute respiratory distress syndrome. Interventions After no improvement with mechanical ventilation and prone positioning, the patient began receiving venovenous extracorporeal membrane oxygenation and was transferred to an extracorporeal membrane oxygenation center. Frontline critical care nurses played a vital role in coordinating patient care activities, monitoring changes in the patient’s condition, and detecting complications early. Outcomes The patient was decannulated on day 15 and extubated on day 17. The patient was successfully discharged home on hospital day 24. Conclusion Caring for a patient with COVID-19 receiving venovenous extracorporeal membrane oxygenation posed unprecedented challenges that required deviations from standards of care to optimize infection control measures and staff safety while providing quality care. This case report may inform, prepare, and guide other critical care nurses who will be caring for similar patients during this pandemic.

scholarly journals Letting the Patient Decide: A Case Report of Self-Administered Sedation During Mechanical Ventilation

2018 ◽  
Vol 38 (1) ◽  
pp. 17-23
Author(s):  
Breanna Hetland ◽  
Sarah Maryon Hayes ◽  
Debra Skaar ◽  
Mary Fran Tracy ◽  
Craig R. Weinert ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Case Report ◽  
Study Protocol ◽  
Pilot Trial ◽  
Critical Care Nurses ◽  
Self Management ◽  
Use Of Self ◽  
Patient Controlled Analgesia ◽  
Ventilator Support

It is common for critical care nurses to administer sedative medications to patients receiving mechanical ventilation. Although patient-controlled analgesia is frequently used in practice to promote effective self-management of pain by patients, it is not known if patient-controlled sedation can be used to promote effective self-management of distressing symptoms associated with mechanical ventilation. A randomized pilot trial was conducted to evaluate whether patient self-administered sedation with dexmedetomidine is safe and acceptable for self-management of anxiety during ventilator support. This case report details the experiences of one patient enrolled in the pilot trial who was randomly assigned to the experimental dexmedetomidine intervention, completed the study protocol, and provided feedback. In a poststudy survey, the patient responded positively to the use of self-administered sedation with dexmedetomidine during ventilator support.

Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Critical Care Unit ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

Adverse Events Reporting System as Experienced by Critical-Care Nurses in KwaZulu-Natal, South Africa

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Thusile Mabel Gqaleni ◽  
Busisiwe Rosemary Bhengu
Keyword(s):  
South Africa ◽  
Critical Care ◽  
Adverse Events ◽  
Patient Care ◽  
Family Involvement ◽  
Reporting System ◽  
Legal Framework ◽  
Critical Care Nurses ◽  
Kwazulu Natal ◽  
Life Threatening

Critically ill patients admitted to critical-care units (CCUs) might have life-threatening or potentially life-threatening problems. Adverse events (AEs) occur frequently in CCUs, resulting in compromised quality of patient care. This study explores the experiences of critical-care nurses (CCNs) in relation to how the reported AEs were analysed and handled in CCUs. The study was conducted in the CCUs of five purposively selected hospitals in KwaZulu-Natal, South Africa. A descriptive qualitative design was used to obtain data through in-depth interviews from a purposive sample of five unit managers working in the CCUs to provide a deeper meaning of their experiences. This study was a part of a bigger study using a mixed-methods approach. The recorded qualitative data were analysed using Tesch’s content analysis. The main categories of information that emerged during the data analysis were (i) the existence of an AE reporting system, (ii) the occurrence of AEs, (iii) the promotion of and barriers to AE reporting, and (iv) the handling of AEs. The findings demonstrated that there were major gaps that affected the maximum utilisation of the reporting system. In addition, even though the system existed in other institutions, it was not utilised at all, hence affecting quality patient care. The following are recommended: (1) a non-punitive and non-confrontational system should be promoted, and (2) an organisational culture should be encouraged where support structures are formed within institutions, which consist of a legal framework, patient and family involvement, effective AE feedback, and education and training of staff.

Late-onset malignant glaucoma

2020 ◽  
Vol 3 ◽  
pp. 1
Author(s):  
Ramiro José Daud ◽  
Horacio Freile ◽  
Mauricio Freile ◽  
Soledad Mariano
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Acute Pain ◽  
Late Onset ◽  
Slit Lamp ◽  
Normal Range ◽  
Slit Lamp Examination ◽  
Complete Occlusion ◽  
Malignant Glaucoma ◽  
The Right

A case report on a 49-year-old female with diagnoses of ocular hypertension in her left eye (LE) treated with 250 mg/day acetazolamide for 2 years. During the slit-lamp examination, complete occlusion of both iridocorneal angles was detected. Intraocular pressure (IOP) was 10 and 35 mmHg in the right eye and LE, respectively. Phacotrabeculectomy was performed in the LE. After 1 month of the procedure, the patient developed a slowly progressive miopization from −1 to −3 diopters (D) the following months. Approximately 3 months after surgery, the patient developed an episode of acute pain, athalamia, and IOP 45 mmHg in her LE. Late-onset malignant glaucoma was suspected and the patient was treated with topical hypotensive and cycloplegic agent until a prompt vitrectomy was performed. Deepening of the anterior chamber and restoration of IOP to normal range was obtained after surgery.

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