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Research Article  |   Volume 2, Issue 1

Addressing Moral Distress in Critical Care Nurses: A Pilot Study

Rose Allen and Eve Butler

Background: Moral distress can affect critical care nurses caring for complex patients. It can result in job dissatisfaction, loss of capacity for caring, and nurse turnover, resulting in a negative impact on quality care. Aim: This study purpose was to determine how moral distress impacts critical care nurses (adult and pediatric) and to implement improvement strategies to reduce moral distress, improve job satisfaction, and retention. Theoretical framework: Nathaniel's Theory of Moral Reckoning was the grounded theory used to show the application of the improvement interventions.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510015

Research Article  |   Volume 2, Issue 1

Use of Transthoracic Impedance Data to Evaluate Intra-arrest Chest Compression Quality

Jonathan W Kamrud, Lori L Boland, Carol L Frazee, Tyler G Kinzy, Paul A Satterlee and Charles J Lick

Mechanical compression devices purportedly improve the quality of chest compressions by minimizing interruptions and maintaining optimal rate and depth, but this claim has not been objectively substantiated using transthoracic impedance (TTI) recordings from applied setting cardiac arrests. In this study, we use TTI data to compare chest compression quality metrics from the manual versus mechanical compression phases of out-of-hospital cardiac arrests (OHCA) treated with the LUCAS™ mechanical compression device.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510014

Research Article  |   Volume 2, Issue 1

Use of Steroid for Extubation Failure due to Stridor in Surgical Intensive Care Patients

Nissar Shaikh, Tasneem Mehesry, Gulzar Hussain, Arshad Chanda, Ali Belkhair, Syed Sheikh, Faisal Malmstrom and Marcus AE

Extubation failure increases morbidity and mortality in intensive care. Laryngeal edema which developed post extubation is one of the major risk factor for extubation failure. Post extubation laryngeal edema occurs in up to 37% of the extubations. Steroids are commonly used pre extubation to prevent development of laryngeal edema. Aim of this study was to find whether steroids can prevent post extubation laryngeal edema and types of patients who frequently fails extubation.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510013

Case Report  |   Volume 2, Issue 1

Almost Total Airway Obstruction Due to Unidentified Massive Hemoptysis under Extracorporeal Membrane Oxygenation

Satoshi Kazuma, Yoshiki Masuda, Hiroomi Tatsumi, Kanako Takahashi, Shinichiro Yoshida, Maiko Honma, Hitoshi Imaizumi and Michiaki Yamakage

A 54-year-old female weighing 62 kg had hemoptysis with an unidentified focus 4 months before and had been followed in the Department of Respiratory Medicine. Angiographic embolization was performed for a right bronchial artery ramification suspected of being the bleeding focus by bronchofiberscopy, but there were few effects. Right middle lobectomy was performed to control the persistent hemoptysis, and tracheal extubation was performed on the second day of illness. Sustained hemoptysis developed again 8 hours after extubation.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510012

Literature Review  |   Volume 2, Issue 1

Inter-hospital Critical Care Transport: Implementation of a Novel Policy and Review of the Literature

Andrea M Pakula, Jannet Gannon, Lisa Mundy, Kathleen Berns, Anita Stoltenberg and Beth A Ballinger

The decision to transport a critically ill patient is based on the need for diagnostic or therapeutic procedures that are not available within the intensive care unit. Most commonly this type of transport is within the home facility and is for procedures such as imaging or for operative intervention. Theoretically, intra-hospital transfers are safer than the transfers to another institution, as transfers outside of the home facility tend to require the coordination of extensive cardio-pulmonary care and monitoring for the critically ill.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510011

Case Report  |   Volume 2, Issue 1

Inadvertent Late Migration of Jugular Catheter and Bilateral Pleural Effusion and Pneumomediastinum

Yiheng Wang, Lixian He, Xiaoling Hu, Zhigang Zhou, Hong Zhou

The authors report an inadvertent late migration of right jugular catheter and the unexpected complications. Postoperative computed tomography reveals bilateral pleural effusion and pneumomediastinum. We speculate that the migration during the maintenance or multiple attempts of placing a guidewire damaged the wall of right brachiocephalic vein or superior vena cava, and punctured through right pleura and anterior mediastinal leading into the complications.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510010