Christopher Decker, Valeda Yong, Julianne E Linahan
{"title":"Critical Care Echocardiography.","authors":"Christopher Decker, Valeda Yong, Julianne E Linahan","doi":"10.4037/aacnacc2023186","DOIUrl":"https://doi.org/10.4037/aacnacc2023186","url":null,"abstract":"Ultrasonography is increasingly applied in the critical care setting. With advancements in technology, ultrasonography has become easier to use, with smaller machines, and more fundamental to patient assessment. Ultrasonography is a hands-on tool that brings real-time, dynamic information to the bedside. Patients in the critical care setting often have unstable hemodynamics or a tenuous respiratory status; thus, the use of ultrasonography to augment the assessment greatly improves patient safety. This article explores how to differentiate the etiology of shock with the adjunct of critical care echocardiography. In addition, the article examines how various ultrasonography techniques can be used to diagnose other life-threatening cardiac conditions, such as pulmonary embolism or cardiac tamponade, and the role of echocardiography in cardiopulmonary resuscitation. Critical care providers can add echocardiography and the information it provides to their repertoire to improve diagnosis, treatment, and patient outcomes.","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"119-128"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9608064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cynthia Blank-Reid, Denise M Zappile, Thomas A Santora
{"title":"Focused and Extended Focused Assessment With Sonography for Trauma.","authors":"Cynthia Blank-Reid, Denise M Zappile, Thomas A Santora","doi":"10.4037/aacnacc2023597","DOIUrl":"https://doi.org/10.4037/aacnacc2023597","url":null,"abstract":"<p><p>Timing is crucial when caring for an injured patient, and the evaluation requires a systematic, rapid, and thorough assessment to identify and treat immediate life-threatening injuries. An integral component of this assessment is the Focused Assessment with Sonography for Trauma (FAST) and the extended FAST (eFAST). These assessments allow for a rapid, noninvasive, portable, accurate, repeatable, and inexpensive means of diagnosing internal injury to the abdomen, chest, and pelvis. Understanding the basic principles of ultrasonography, having a thorough familiarity with the equipment, and being knowledgeable in anatomy allow the bedside practitioner to use this tool to rapidly assess injured patients. This article reviews the basic tenets that underpin the FAST and eFAST evaluations. Practical interventions and tips are provided to assist novice operators-all with the goal of decreasing the learning curve.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"129-138"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9608063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristina A Wojack, Anna M Marrocco, Jeanne Caitlyn Enstrom, Jesus Casida
{"title":"Thromboelastography: A Novel Approach to Hemostasis in Cardiac Surgery.","authors":"Cristina A Wojack, Anna M Marrocco, Jeanne Caitlyn Enstrom, Jesus Casida","doi":"10.4037/aacnacc2023957","DOIUrl":"10.4037/aacnacc2023957","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"139-144"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicole Robbins, Sara Gandora, Kenneth J Oja, David C Mulkey
{"title":"Competency Assessment of Pediatric Intensive Care Nurses.","authors":"Nicole Robbins, Sara Gandora, Kenneth J Oja, David C Mulkey","doi":"10.4037/aacnacc2023556","DOIUrl":"https://doi.org/10.4037/aacnacc2023556","url":null,"abstract":"<p><p>One of the biggest challenges that clinical nurse educators at the unit level face today is measuring the ongoing competency of nursing staff members to ensure provision of high-quality, evidence-based care. Pediatric nursing leaders at an urban, level I trauma teaching institution in the southwestern United States used a shared governance approach to create a standardized competency assessment tool for pediatric intensive care unit nurses. Donna Wright's competency assessment model was used as a framework to guide the tool's development. The adoption of the standardized competency assessment tool was aligned with the organization's institutional goals and enabled clinical nurse educators to comprehensively evaluate staff members on a regular basis. This standardized competency assessment system for pediatric intensive care nurses is more effective than use of a practice-based, task-oriented assessment method and has improved nursing leaders' ability to staff the pediatric intensive care unit safely.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"95-102"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kerri O Kennedy, Deirdre F Puccetti, Jonathan M Marron, Stephen D Brown
{"title":"Potentially Inappropriate Treatment: Competing Ethical Considerations.","authors":"Kerri O Kennedy, Deirdre F Puccetti, Jonathan M Marron, Stephen D Brown","doi":"10.4037/aacnacc2023884","DOIUrl":"https://doi.org/10.4037/aacnacc2023884","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"161-167"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10365317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pulmonary Point-of-Care Ultrasonography in the Intensive Care Unit.","authors":"Shameek Gayen, Jin Sun Kim, Parag Desai","doi":"10.4037/aacnacc2023550","DOIUrl":"https://doi.org/10.4037/aacnacc2023550","url":null,"abstract":"<p><p>Pulmonary point-of-care ultrasonography (POCUS) is a quick and essential tool in the diagnosis of various pulmonary pathologies. Pulmonary POCUS can aid in the detection of pneumothorax, pleural effusion, pulmonary edema, and pneumonia, with sensitivity and specificity comparable, if not superior, to those of chest radiograph and chest computed tomography. Knowledge of anatomy and scanning of both lungs in multiple positions is essential for effective pulmonary POCUS. In addition to identifying pertinent anatomic structures such as the diaphragm, liver, spleen, and pleura and identifying specific ultrasonography findings such as A-lines, B-lines, lung sliding, and dynamic air bronchograms, POCUS helps detect pleural and parenchymal abnormalities. Proficiency in pulmonary POCUS is an attainable and essential skill in the care and management of the critically ill patient.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"113-118"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Why Meaningful Recognition and Gratitude Are Important in Addressing Staffing Shortages.","authors":"Nancy Blake","doi":"10.4037/aacnacc2023812","DOIUrl":"10.4037/aacnacc2023812","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"145-147"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}