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Intensive care, critical care, pain

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https://www.readbyqxmd.com/read/28431797/video-education-for-critical-care-nurses-to-assess-pain-with-a-behavioural-pain-assessment-tool-a-descriptive-comparative-study
#1
Annika Björn, Sanna-Mari Pudas-Tähkä, Sanna Salanterä, Anna Axelin
AIM: To evaluate the impact of video education on critical care nurses' knowledge and skills in using a behavioural pain assessment tool for intensive care patients and to explore the nurses' experiences with video education. METHODS: Forty-eight nurses in one intensive care unit watched an educational video on the use of the Critical-Care Pain Observation Tool, then assessed pain in two patients with the tool and took a knowledge test. The researcher made parallel pain assessments...
April 18, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#2
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28388599/abcb1-genotype-is-associated-with-fentanyl-requirements-in-critically-ill-children
#3
Christopher M Horvat, Alicia K Au, Yvette L Conley, Patrick M Kochanek, Lingjue Li, Samuel L Poloyac, Philip E Empey, Robert S B Clark
BACKGROUND: The gene ABCB1 encodes p-glycoprotein, a xenobiotic efflux pump capable of transporting certain opioids, including fentanyl. ABCB1 genotype has been previously associated with patient opioid requirements and may influence fentanyl dosing requirements in critically ill children. METHODS: A diagnostically diverse cohort of 61 children who received a fentanyl infusion while admitted to the pediatric intensive care unit (PICU) were included in this study...
April 7, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28375992/pain-agitation-and-delirium-guidelines-interprofessional-perspectives-to-translate-the-evidence
#4
Juliane Jablonski, Jaime Gray, Todd Miano, Gretchen Redline, Heather Teufel, Tara Collins, Jose Pascual-Lopez, Martha Sylvia, Niels D Martin
BACKGROUND: Societal guidelines exist for the management of pain, agitation, and delirium (PAD) in critically ill patients. This contemporary practice aims for a more awake and interactive patient. Institutions are challenged to translate the interrelated multivariable concepts of PAD into daily clinical practice and to demonstrate improvement in quality outcomes. An interdisciplinary goal-directed approach shows outcomes in high-acuity surgical critical care during the early stages of implementation...
May 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28363365/chest-wall-trauma
#5
REVIEW
Sarah Majercik, Fredric M Pieracci
Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28362678/the-behavior-pain-assessment-tool-for-critically-ill-adults-a-validation-study-in-28-countries
#6
Céline Gélinas, Kathleen A Puntillo, Pavel Levin, Elie Azoulay
Many critically ill adults are unable to communicate their pain through self-report. The study purpose was to validate the use of the 8-item Behavior Pain Assessment Tool (BPAT) in patients hospitalized in 192 intensive care units from 28 countries. A total of 4812 procedures in 3851 patients were included in data analysis. Patients were assessed with the BPAT before and during procedures by 2 different raters (mostly nurses and physicians). Those who were able to self-report were asked to rate their pain intensity and pain distress on 0 to 10 numeric rating scales...
May 2017: Pain
https://www.readbyqxmd.com/read/28362033/methods-of-pain-assessment-in-adult-intensive-care-unit-patients-polish-version-of-the-cpot-critical-care-pain-observation-tool-and-bps-behavioral-pain-scale
#7
Katarzyna Kotfis, Małgorzata Zegan-Barańska, Łukasz Szydłowski, Maciej Żukowski, Wes E Ely
Many patients treated in the intensive care unit (ICU) experience pain that is a source of suffering and leaves a longterm imprint (chronic pain, post-traumatic stress disorder). Nearly 30% of patients experience pain at rest, while the percentage increases to 50% during nursing procedures. Pain in ICU patients can be divided into four categories: continuous ICU treatment-related pain/discomfort, acute illness-related pain, intermittent procedural pain and pre-existing chronic pain present before ICU admission...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28358177/survey-on-monitoring-analgesia-and-sedation-in-the-italian-pediatric-intensive-care-units
#8
Benedicta Tabacco, Claudio Tacconi, Angela Amigoni
BACKGROUND: Admission in Pediatric Intensive Care Unit requires management and monitoring of analgesia and sedation, in order to reduce their adverse effects, and to prevent withdrawal syndrome and delirium. The aim of this study is to evaluate the management of analgesia and sedation in critically ill children admitted in the Italian Pediatric Intensive Care Units. METHODS: For this survey we have submitted a telematics questionnaire to 24 nursing co- ordinators of the Pediatric Intensive Care Units or Neonatal Intensive Care Units admitting critically ill children...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28357623/impact-of-pharmaceutical-care-on-pain-and-agitation-in-a-medical-intensive-care-unit-in-thailand
#9
Pitchaya Dilokpattanamongkol, Viratch Tangsujaritvijit, Thanarat Suansanae, Chuthamanee Suthisisang
Background Currently, a lack of pharmaceutical care exists concerning pain and agitation in medical intensive care units (MICU) in Thailand. Pharmaceutical care focusing on analgesics/sedatives would improve clinical outcomes. Objective To investigate the impact of pharmaceutical care of pain and agitation on ICU length of stay (LOS), hospital LOS, ventilator days and mortality. Setting The MICU of a university hospital. Method A before/after study was conducted on mechanically ventilated patients receiving analgesics/sedatives...
March 29, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28343092/the-impact-of-cumulative-pain-stress-on-neurobehavioral-development-of-preterm-infants-in-the-nicu
#10
Xiaomei Cong, Jing Wu, Dorothy Vittner, Wanli Xu, Naveed Hussain, Shari Galvin, Megan Fitzsimons, Jacqueline M McGrath, Wendy A Henderson
BACKGROUND: Vulnerable preterm infants experience repeated and prolonged pain/stress stimulation during a critical period in their development while in the neonatal intensive care unit (NICU). The contribution of cumulative pain/stressors to altered neurodevelopment remains unclear. The study purpose was to investigate the impact of early life painful/stressful experiences on neurobehavioral outcomes of preterm infants in the NICU. METHODS: A prospective exploratory study was conducted with fifty preterm infants (28 0/7-32 6/7weeks gestational age) recruited at birth and followed for four weeks...
March 23, 2017: Early Human Development
https://www.readbyqxmd.com/read/28338811/interventions-for-the-prevention-and-treatment-of-disability-due-to-acquired-joint-contractures-in-older-people-a-systematic-review
#11
Susanne Saal, Katrin Beutner, Julia Bogunski, Kathrin Obermüller, Martin Müller, Eva Grill, Gabriele Meyer
Background: acquired joint contractures have significant effects on quality of life and functioning. Objective: to determine the effects of interventions to prevent and treat disabilities in older people with acquired joint contractures. Methods: systematic search (last 8/2016) via Cochrane Library, PubMed, EMBASE, PEDro, CINAHL, trial registries, reference lists of retrieved articles and scientific congress pamphlets. Controlled and randomised controlled trials in English or German comparing an intervention with another intervention or standard care were included...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28325699/spinal-correction-in-patients-with-fukuyama-congenital-muscular-dystrophy
#12
Wataru Saito, Takanori Namba, Gen Inoue, Takayuki Imura, Masayuki Miyagi, Toshiyuki Nakazawa, Eiki Shirasawa, Kentaro Uchida, Masashi Takaso
BACKGROUND: Fukuyama congenital muscular dystrophy (FCMD) is one of the most common congenital progressive muscular dystrophies in Japan. Some patients develop a severe spinal deformity that leads to an unstable sitting position or pain. Since 2008, we have treated FCMD using posterior spinal fusion. This study reports the short-term clinical and radiographic results of posterior spinal correction and fusion in FCMD. METHODS: We retrospectively reviewed 11 consecutive FCMD patients, average age 13 years old, treated with posterior spinal instrumentation and fusion between 2008 and 2015...
March 18, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28284292/the-abcdef-bundle-in-critical-care
#13
REVIEW
Annachiara Marra, E Wesley Ely, Pratik P Pandharipande, Mayur B Patel
The ABCDEF bundle represents an evidence-based guide for clinicians to approach the organizational changes needed for optimizing intensive care unit patient recovery and outcomes. This article reviews the core evidence and features behind the ABCDEF bundle. The bundle has individual components that are clearly defined, flexible to implement, and help empower multidisciplinary clinicians and families in the shared care of the critically ill. The ABCDEF bundle helps guide well-rounded patient care and optimal resource utilization resulting in more interactive intensive care unit patients with better controlled pain, who can safely participate in higher-order physical and cognitive activities at the earliest point in their critical illness...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28279266/parallels-between-astronauts-and-terrestrial-patients-taking-physiotherapy-rehabilitation-to-infinity-and-beyond
#14
Julie Hides, Gunda Lambrecht, Gita Ramdharry, Rebecca Cusack, Jacob Bloomberg, Maria Stokes
Exposure to the microgravity environment induces physiological changes in the cardiovascular, musculoskeletal and sensorimotor systems in healthy astronauts. As space agencies prepare for extended duration missions, it is difficult to predict the extent of the effects that prolonged exposure to microgravity will have on astronauts. Prolonged bed rest is a model used by space agencies to simulate the effects of spaceflight on the human body, and bed rest studies have provided some insights into the effects of immobilisation and inactivity...
January 2017: Musculoskeletal Science & Practice
https://www.readbyqxmd.com/read/28263377/the-frailty-phenotype-and-palliative-care-needs-of-older-survivors-of-critical-illness
#15
Lauren R Pollack, Nathan E Goldstein, Wendy C Gonzalez, Craig D Blinderman, Mathew S Maurer, David J Lederer, Matthew R Baldwin
OBJECTIVES: To assess symptoms in older intensive care unit (ICU) survivors and determine whether post-ICU frailty identifies those with the greatest palliative care needs. DESIGN: A prospective cohort study. SETTING: Urban tertiary care hospital and community hospital. PARTICIPANTS: Medical ICU survivors of mechanical ventilation aged 65 and older (N = 125). MEASUREMENTS: Baseline measurements of the Edmonton Symptom Assessment Scale (ESAS), categorized as mild (0-3), moderate (4-6), and severe (7-10), and the frailty phenotype were made during the week before hospital discharge...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28257549/analysis-of-intensive-care-unit-admission-and-sequelae-in-patients-intravenously-abusing-extended-release-oral-oxymorphone
#16
Matthew W Wilson, Alex K Bonnecaze, Ajay Dharod, Peter J Miller
OBJECTIVES: Prescription drug abuse is a major public health problem in the United States, with the rate of opioid-related deaths nearly quadrupling between 2000 and 2014. Extended-release oral oxymorphone hydrochloride (Opana ER) is a long-acting opioid prescribed for chronic pain; however, it also has the potential to be abused via intravenous injection. This retrospective review sought to analyze specific complications and sequelae requiring intensive care unit resources for patients intravenously abusing extended-release oral oxymorphone...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28237616/defining-the-diagnostic-value-of-hyperlipasemia-for-acute-pancreatitis-in-the-critically-ill
#17
Jonah Cohen, Kristin L MacArthur, Amporn Atsawarungruangkit, Michael C Perillo, Camilia R Martin, Tyler M Berzin, Nathan I Shapiro, Mandeep S Sawhney, Steven D Freedman, Sunil G Sheth
BACKGROUND/OBJECTIVES: Hyperlipasemia is frequently encountered in patients in the intensive care unit (ICU). The degree to which it should be valued in making the diagnosis of acute pancreatitis (AP) in critically ill patients remains uncertain. We sought to determine the diagnostic accuracy of hyperlipasemia and the optimal lipase cutoff for diagnosing AP in critically ill patients. METHODS: Four hundred and seventeen ICU patients with hyperlipasemia, defined as lipase greater than three times the upper limit of normal from 2009 to 2012 were retrospectively identified...
February 8, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28236329/unpacking-the-burden-of-care-for-infants-in-the-nicu
#18
Amy L D'Agata, Marilyn R Sanders, Damion J Grasso, Erin E Young, Xiaomei Cong, Jacqueline M Mcgrath
Infants who begin early life in the medicalized environment of the neonatal intensive care unit (NICU) experience disruption to numerous fundamental expectancies. In the NICU, infants are exposed to chronic, extreme stressors that include painful medical procedures and parental separation. Due to their preverbal stage of development, infants are unable to fully express these experiences, and linking these experiences to long-term outcomes has been difficult. This clinical article proposes the terminology Infant Medical Trauma in the NICU (IMTN) to describe the infant experience...
March 2017: Infant Mental Health Journal
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#19
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28194277/risk-factors-and-prognosis-of-pain-events-during-mechanical-ventilation-a-retrospective-study
#20
Ayahiro Yamashita, Masaki Yamasaki, Hiroki Matsuyama, Fumimasa Amaya
BACKGROUND: Pain assessment is highly recommended in patients receiving mechanical ventilation. However, pain intensity and its impact on outcomes in these patients remain obscure. We collected the results of routine pain assessments, utilizing the behavioral pain scale (BPS), from 151 patients receiving mechanical ventilation. Risk factors associated with a pain event, defined as BPS of >5, and its impact on patient outcomes were investigated. METHODS: A total of 151 consecutive adult patients receiving mechanical ventilation for more than 24 h in a single 10-bed ICU were enrolled in this study...
2017: Journal of Intensive Care
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