Critical Care Nursing Quarterly

The onset of the COVID-19 pandemic has led to an increased use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS); however, there are ongoing concerns about its associated risks and benefits, making a comprehensive understanding vital for clinical decision-making. This review aims to evaluate the efficacy, risks, and practical implications of ECMO as a therapeutic intervention in severe ARDS secondary to COVID-19. The results indicate that ECMO is a key therapeutic intervention for managing severe COVID-19, but due to its associated risks and resource constraints, its application needs careful consideration...

No abstract text is available yet for this article.

Asthma is a common chronic respiratory condition that affects approximately 10% of adult women in the United States. Pregnancy can present unique challenges for women with asthma, as changes in the body can alter the severity and management of asthma-related respiratory symptoms. In this article, we review the current understanding of asthma during pregnancy, including the direct effects of the disease state on the pregnant woman and fetus, risk factors for poor control of disease, as well as current treatment recommendations...

Female patients are at a greater risk for infections such as urinary tract infections and mastitis, as well as complications from abortions/miscarriages, and sexually transmitted infections. This review highlights risk factors, pathogenesis, complications, diagnostic, and treatment modalities associated with the following infections: mastitis, sexually transmitted diseases, postpartum/abortion-related infections, and urinary tract infections.

This review article provides a comprehensive overview of common medical emergencies that can occur in pregnant patients. We summarize the key diagnostic and management steps for each emergency to assist health care professionals in identifying and treating these potentially life-threatening conditions. The medical emergencies discussed in this article include postpartum hemorrhage; hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome; acute fatty liver of pregnancy; amniotic fluid embolism; pulmonary embolism; acute respiratory distress syndrome; and shock...

Trauma in pregnancy can range from a mild injury, such as a fall from standing height, to a major injury, involving a penetrating injury or a high force motor vehicle collision. Providing care to a pregnant patient with trauma presents a unique challenge as 2 patients are at risk for complications, that is, the mother and the fetus, both of whom require evaluation and management. Health care professionals should be aware of and be prepared to manage complications of trauma in pregnancy, given its significant associated morbidity and mortality...

Fetal monitoring in the intrapartum and peripartum periods is important for the well-being of both baby and mother. Electronic fetal monitoring was first designed over 50 years ago in an attempt to improve perinatal outcomes. Its purpose is to assess fetal oxygenation and acid-base status during the antepartum course when indicated and during labor. Maternal assessment begins early in gestation with blood pressure monitoring and urine protein excretion to diagnose potential complications, such as severe hypertension and preeclampsia/eclampsia...

Hypertension has been shown to have long-term cardiovascular effects if left untreated. Hypertension also has been shown to affect women during pregnancy, which can be detrimental not only to the patient but also to the fetus. Early identification and treatment are paramount to prevent adverse outcomes. This article details the epidemiology, clinical presentation, diagnosis, and treatment of essential hypertension in women, gestational hypertension, preeclampsia, and eclampsia.

Cardiovascular disease is a leading cause of death for women in the United States. This article encompasses the epidemiology/etiology, clinical presentation, diagnostic assessment, management, and prognosis of some common cardiovascular disorders seen in women with a special focus on pregnancy.

Despite the increasing number of women within medical professions, gender equality in career advancement and leadership positions still remains a challenge due to numerous barriers including unbalanced domestic responsibilities, discrimination, and rigidity in career structures. Here, we discuss ways to achieve work-life balance and family planning as well as some of the challenges women face in medicine and nursing careers and outline strategies for individuals and organizations to overcome them.

Mental health illness has been increasing worldwide. The prevalence of mental illness and is higher among females than among males. It is estimated that one in 5 women experience a common mental health disorder. This article highlights gender disparities in the risk, prevalence, and presentation of different mental health disorders. Nearly all survivors of critical illness experience 1 or more domains of the post-intensive care syndrome. We review different mental health disorders including anxiety disorders, mood disorders, psychotic disorders, and post-intensive care syndrome, and medications used to manage these disorders...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Intensive care unit (ICU) nurses are repetitively exposed to traumatic situations and stressful events, which can lead to compassion fatigue (CF). Compassion fatigue can negatively affect the nurses' emotional and physical health and job satisfaction. The aim of this study was to evaluate the relationship between CF and nursing care quality in ICU. This descriptive-correlational study was conducted on 46 ICU nurses and 138 ICU patients, in 2 referral hospitals in Gorgan, Northeast of Iran in 2020. Participants were selected using stratified random sampling...

This article reports results of a nurse-driven fluid management protocol in a medical-surgical intensive care unit (ICU). Use of static measures such as central venous pressure monitoring, heart rate, blood pressure, and urine output is poor predictors of fluid responsiveness and can result in inappropriate fluid administration. Indiscriminate administration of fluid can result in prolonged mechanical ventilation time, increased vasopressor requirements, increased length of stay, and greater costs. Use of dynamic preload parameters such as stroke volume variation (SVV), pulse pressure variation, or changes in stroke volume with a passive leg raise has been shown to be more accurate predictors of fluid responsiveness...

More than 1 million falls are reported in US hospitals each year. Psychiatric inpatients are at high risk for self-harm behaviors with reported suicide rate of 6.5 per 1000 patients. Patient observation is the primary risk management intervention in preventing adverse patient safety incidents. This project aimed to examine the effectiveness of handheld electronic rounding board (ObservSMART) implementation on falls and self-harm incidents among psychiatric inpatients. A retrospective review of adverse patient safety incidents was conducted to compare the 6-month preimplementation period versus the 6-month postimplementation period with staff training and implementation in July 2019...

This article reports a study that was designed to describe the incidence of pain among older hospitalized patients with dementia and to evaluate the factors that influence pain among these individuals. It was hypothesized that function, behavioral and psychological symptoms of dementia, delirium, pain treatment, and patient exposure to care interventions would be associated with pain. Patients who performed more functional activities had less delirium. They also experienced higher quality-of-care interactions and were less likely to have pain...

Each day, across America, people come to emergency service providers in need of care and support. Although not ideal, emergency departments have become the de facto outpatient treatment center in many communities. This positions emergency department providers to be ideal partners in the treatment of substance use disorders. Substance use and deaths by overdose have been of great concern for many years, and since the start of the pandemic, the trends have caused further concern. Drug overdoses have claimed the lives of more than 932 000 Americans over the past 21 years...

This article discusses a quality improvement study conducted on intensive care unit (ICU) staff nurses that assessed their ability to utilize the CAM-ICU tool for delirium detection properly. Staff members' expertise in identifying and managing delirious patients directly correlates with reducing the long-term sequelae associated with ICU delirium. The cohort of ICU nurses participating in this research study took a questionnaire on 4 separate occasions. The survey ascertained quantitative and qualitative data, reflecting personal knowledge about the CAM-ICU tool and delirium...

In the last 20 years, the occurrences of drug shortages have increased in frequency as well as duration before returning to the mainstream market. This has prompted intensive care unit nurses and medical staff to seek alternate medication infusion options that provide safe yet effective sedation for patients admitted to intensive care units across the country. Dexmedetomidine (PRECEDEX) emerged in 1999 after the Federal Drug Administration approved it for intensive care use but was quickly embraced by anesthesia providers as it rendered patients undergoing procedures or surgery with adequate analgesia and sedation...