A portable Computed Tomography (CT) is used to manage and diagnose CNS diseases, and acute brain injuries, in the Neuroscience ICU (NICU), for example, Traumatic Brain Injuries(TBI), acute strokes, (transient ischemic attack) TIA’s, and subarachnoid hemorrhage (SAH). CT studies are an important component in the assessment and management of patients with brain injuries. The portable device is designed specifically for head and neck scans for critically ill patients that are at risk for complications and increased morbidity during intrahospital transportation. Researchers have studied and found evidence that substantiates that intrahospital transport of patients with SAH or brain injuries can affect their outcomes. Many hospital protocols dictate the use of portable head CT (pHCT) scanners to monitor and assess critically ill patients in the NICU, to decrease negative effects of intrahospital transportation on patient outcomes. This is an important factor in reduction and prevention secondary injuries in critically ill patients. The intention of this paper is to conduct a critical analysis of a related research article. The article reviewed is Portable Head CT Scan and its Effect on Intracranial Pressure (ICP), Cerebral Perfusion Pressure (CPP), and Brain Oxygen. First, there will be an identification of the premise of the study through an article synopsis. Second, validity of the study will be described and discussed. Lastly, this paper will discuss how this research is applicable to Neuro ICU at UNM Hospital. Article Synopsis: The authors of this research article were from the Departments of Neurosurgery, Neurology, Anesthesiology & Critical Care, Nursing, and Biostatistics & Epidemiology from the University of Pennsylvania... ... middle of paper ... ... The research conducted by Peace et.al. raises a valid hypothesis that warrants further study in order to decrease the risks to patients on NICU and other units, in all hospitals. Studies with significant reliability data, high internal and external validity, are imperative in making changes in hospitals around the world to decrease secondary injury to patient populations and increasing their chances of full recovery from their injuries. Although, this particular study resulted in preliminary data, similar protocols found in this study are implemented by the UNM NICU. Works Cited Peace, K., Maloney-Wilensky, E., Frangos, S., Hujcs, M., Levine, J., Kofke, W.A., Yang, W., & Le Roux, P.D. (2011). Portable head CT scan and its effect on intracranial pressure, cerebral perfusion pressure, and brain oxygen. Journal of Neurosurgery, 114(5), 1479-1484.
...severe head injury. Journal of Trauma [serial online]. December 2000; 49(6):1065-1070. Available from: CINAHL Plus, Ipswich, MA. Accessed March 7, 2014.
Since neonatal nursing is my special interest and field, I chose to write about the health care options which are available to parents having children in different hospitals throughout the world. With the state of the art technological advances in the neonatal units, there are so many options available for the care of newborn babies. I reviewed the neonatal units in Australia, Saudi Arabia, New York, Tokyo, Ireland, and California, and I have learned what It takes to run a neonatal intensive care unit all around the world.
UB was only struck in the back of the head; however, as a result of countercoup movement, bleeding appeared in multiple areas of the brain. U.B. was jogging when a large truck struck him. Therefore, he was in motion when was hit on the back of the head by the side mirror of a truck moving in the same direction as him. Thus, he experienced an accelerating TBI (Walker, 1997, p. 9). In a closed head injury, the primary head injury occurred where he was struck in the back of the head, the coup, and the place that is point opposite of where he was struck (contra-coup). In U.B.’s case, the coup is the occipital lobe and the brain stem, as he was struck by the truck mirror on the back of the head. The contra-coup is the frontal lobe. Therefore, when
Volles, D. F. (2011, April 11). University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures. Retrieved May 12, 2011, from University of Virgina Health System: University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures
Neonatal intensive care units are normally thought as a safe place for a neonatal to be, but there are instances where the neonatal develops an infection in their fragile bodies. This paper examines the ways that they could develop infections that harm them. The ANA states, “individuals who become nurses are expected to adhere to the ideals and morals norms of the profession and also to embrace them as a part of what it means to be a nurse.” (Code of Ethics, n.d.). German NICUs participated in a study of very low birth weight infants (VLBW) from 2006-2011 and found that an outbreak of severe neonatal infection occurred within a period of time in the same center in four different patients (Schwab, 2014).
Epidural hematomas are a severe complication of head injuries and are considered to be a medical emergency. Although they may not be seen as often as subdural hematomas, they are much more serious and require emergency surgery. If epidural hematomas are not picked up quickly, they can result in severe neurologic deficits and even worse, death. A major concern in a patient with an epidural hematoma is failure to rescue by healthcare professionals. Failure to rescue is when healthcare professionals do not notice signs of a patients declining condition and subsequently fail to stabilize the patient (Gravey, 2015, p.145). This has become an increasing problem and has lead to numerous preventable disabilities and death. In order to avoid unnecessary harm to our patients it is essential that nurses are able to detect and notify any suspicion of epidural hematomas. Since nurses spend the majority of the time with the patient, they hold a significant role in early detection.
The interdisciplinary team will be formed where the members will consist of a Neurologist as a physician champion, a speech language pathologist (SLP), nursing leadership from the emergency department (ED), representation form the Quality Improvement (QI) Department, Stroke Coordinator, Nurse Practitioner (NP) from the stroke team, and research nurse. The pre-work will be completed where the DS chosen by the facility will be determined and the ability of the informatics technology department to place the DS protocol within the existing order sets will be achievable. Also, the QI department will have available data of PN rates in the stroke patient population as well as DS completion. This team will present the proposal to stakeholders of administration and physicians where the evidence with data will be articulated, the protocol will be presented as well as cost for training of caregivers (Donovan, 2013). This method will provide support from leadership; the process will be provided to staff nurses in the ED and the stroke unit by their managers.
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
The primary function of a Neurological NPs is to facilitate the surgery collaborating with the number of surgeons for the pre and post-operations. Their principal purpose includes assessment and management of the patient by applying clinical knowledge but is not limited to refer patients to specialists, ordering diagnostic investigations and prescribing medications. A neurosurgery NP's roles are to diagnose test (CT scans and MRI's), treat plus manage patients with neurological and neurosurgical conditions. They are taught to practice holistically and to work in partnership with the patient while cooperating to facilitate the wellbeing of health instead of treating symptoms. An NP must assess patients to perform a physical exam, review scans and other clinical diagnostic information. After handling the test data, an NP is obliged to make a diagnosis with a selected appropriate treatment, set medical purpose, implement the treatment and evaluate the effect of the
...tracranial pressure from brain edema. Interventions include administering osmotic diuretics, maintaining partial pressure of carbon dioxide, and positioning to avoid hypoxia. Other treatment measures include elevating the head of the bed to promote venous drainage and to lower ICP.
Sole, M.L., Klein, D.G., & Moseley, M.J. (2013). Introduction to critical care nursing (6th ed). St. Louis, MO: Elsevier.
We were nervous when giving care to the child alone without having a supervisor with adequate PICU training. we had our anxious moments with our outdated equipment. We had doubts and confusion on calculations of certain drugs seldom used in emergency. At times we were emotionally strained and upset with the reactions of some pediatricians. We were concerned that pediatricians would expect more from us than our capability. In view of considering the prognosis of critically ill child, we were in dilemma to give hope for the family about the recovery of the child.
Patient safety must be the first priority in the health care system, and it is widely accepta-ble that unnecessary harm to a patient must be controlled.Two million babies and mother die due to preventable medical errors annually worldwide due to pregnancy related complications and there is worldwide increase in nosocomial infections, which is almost equal to 5-10% of total admissions occurring in the hospitals. (WHO Patient Safety Research, 2009). Total 1.4 million patients are victims of hospital-acquired infection. (WHO Patient Safety Research, 2009). Unsafe infection practice leads to 1.3 million death word wide and loss of 26 millions of life while ad-verse drug events are increasing in health care and 10% of total admitted patients are facing ad-verse drug events. (WHO Patient Safety Re...
There is a handful of tools to diagnose a patient rapidly. For example, the Glasgow Coma Scale is a 15-point test which helps a doctor or other emergency medical personnel assess the initial severity of a brain injury. The scale is used to analyze a person ability to follow directions with verbal responses, motor skill responses, and eye responses. Abilities are scored numerically in the Glasgow Coma Scale. Higher scores mean the injury is less severe. Using the Glasgow Coma Scale when a reporting a possible traumatic brain injury, it may be possible to provide medical personnel with information that's useful in assessing the injured person's condition. Some tools that can help diagnose a patient even more in depth are a CT scan. A CT scan uses a series of X-rays to create a detailed view of the brain. A CT scan can quickly visualize fractures and uncover evidence of bleeding in the brain, blood clots, bruised brain tissue, and brain tissue swelling which will most likely give care providers an idea how to treat and whether or not immediate life threats may be
Paramedics are frequently presented with neurological emergencies in the pre-hospital environment. Neurological emergencies include conditions such as, strokes, head or spinal injuries. To ensure the effective management of neurological emergencies an appropriate and timely neurological assessment is essential. Several factors are associated with the effectiveness and appropriateness of neurological assessments within the pre-hospital setting. Some examples include, variable clinical presentations, difficulty undertaking investigations, and the requirement for rapid management and transportation decisions (Lima & Maranhão-Filho, 2012; Middleton et al., 2012; Minardi & Crocco, 2009; Stocchetti et al., 2004; Yanagawa & Miyawaki, 2012). Through a review of current literature, the applicability and transferability of a neurological assessment within the pre-hospital clinical environment is critiqued. Blumenfeld (2010) describes the neurological assessment as an important analytical tool that evaluates the functionality of an individual’s nervous system. Blumenfeld (2010) dissected and evaluated the neurological assessment into six functional components, mental status, cranial nerves, motor exam, reflexes, co-ordination and gait, and a sensory examination.