The Southern African journal of critical care : the official journal of the Critical Care Society最新文献_第10页

Sugar, Pressure and Pregnancy 糖、压力和怀孕

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2017-07-11 DOI: 10.7196/SAJCC.337

W. L. Michell

引用次数: 0

The need for setting standards in critical care transfers 制定重症监护转院标准的必要性

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2017-07-11 DOI: 10.7196/SAJCC.2017.V33I1.319

M. Venter, D. Stanton, N. Conradie, L. Jordaan, C. Venter, W. Stassen

引用次数: 7

Correlation between different methods of intra-abdominal pressure monitoring in varying intra-abdominal hypertension models 不同腹内高压模型中不同腹内压监测方法的相关性

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2017-07-11 DOI: 10.7196/SAJCC.2017.V33I1.327

R. Wise, R. Rodseth, L. Correa-Martín, F. M. S. Margallo, P. Becker, G. Castellanos, M. Malbrain

引用次数: 3

Glycaemic control in a cardiothoracic surgical population: Exploring the protocol-practice gap 心胸外科人群的血糖控制:探索方案与实践的差距

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2017-07-11 DOI: 10.7196/SAJCC.2017.V33I1.280

D. Maharaj, H. Perrie, J. Scribante, F. Paruk

{"title":"Glycaemic control in a cardiothoracic surgical population: Exploring the protocol-practice gap","authors":"D. Maharaj, H. Perrie, J. Scribante, F. Paruk","doi":"10.7196/SAJCC.2017.V33I1.280","DOIUrl":"https://doi.org/10.7196/SAJCC.2017.V33I1.280","url":null,"abstract":"Background . Glycaemic control constitutes an important component in the management of critically ill patients. As such, all healthcare workers involved in the management of critically ill patients need to ensure that it is achieved adequately. To avoid glucose variability and to maintain normoglycaemia, evidence-based protocols are implemented to guide clinical care. However, it has been suggested that with the use of protocoldirected therapy, protocol-practice gaps are common and therefore protocol adherence must be audited regularly. The aim of this study was to evaluate adherence to the glucose control protocol by nurses in the cardiothoracic intensive care unit (ICU) at a tertiary academic hospital. Methods . A retrospective study involving the review of ICU charts of all post-cardiac surgery patients ≥16 years admitted to the cardiothoracic ICU during March 2011. A convenience sampling method was used. Results . A total of 741 glucose readings for 22 patients were evaluated. The median (interquartile range) glucose reading was 7.8 mmol/L (6.7 - 9.3 mmol/L). Overall, 411 (55.5%) protocol violations were recorded and 629 (84.9%) of the total readings were abnormal. Protocol violations were similar between the day and night staff; 188 (54.7%) and 223 (58.5%) were recorded, respectively ( p =0.256). Of the readings, 464 (62.6%) were conducted by ICU-trained nurses and 245 (33.2%) by non-ICU-trained nurses. There were fewer protocol violations recorded by the ICU-trained nurses compared with the non-ICU-trained nurses, i.e. 53.3% and 63.7%, respectively ( p <0.05). Conclusion . Adherence to the glucose-control protocol was suboptimal. These results may suggest that the training and education of healthcare workers in implementing protocols is an ongoing and dynamic process, and that there is a need for the regular evaluation of protocol adherence in order to identify protocol-practice gaps.","PeriodicalId":75194,"journal":{"name":"The Southern African journal of critical care : the official journal of the Critical Care Society","volume":"8 1","pages":"4-7"},"PeriodicalIF":0.0,"publicationDate":"2017-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73161357","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}

引用次数: 1

Obstetric patients admitted to the intensive care unit of Dr George Mukhari Academic Hospital, Ga-Rankuwa, South Africa 南非加兰库瓦George Mukhari博士学术医院重症监护室的产科病人

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2017-07-11 DOI: 10.7196/279

M. Motiang

{"title":"Obstetric patients admitted to the intensive care unit of Dr George Mukhari Academic Hospital, Ga-Rankuwa, South Africa","authors":"M. Motiang","doi":"10.7196/279","DOIUrl":"https://doi.org/10.7196/279","url":null,"abstract":"Background . Pregnancy is a natural physiological process that normally ends uneventfully. However, there are instances where admission to an intensive care (ICU) is required. Objectives . To determine the spectrum of disease requiring ICU admission in obstetric patients, condition on discharge, maternal mortality, and the cause of maternal death. Methods . A retrospective study of all pregnant and postpartum patients admitted from January 2008 to December 2011 was conducted. Outcome measures were the spectrum of disease, ICU interventions, and maternal outcomes. Results . In total, 210 patients were reviewed. The mean age was 28.15 (standard deviation (SD) 6.97) years. Twelve (5.7%) patients were admitted at a mean (SD) gestational age of 25.33 (6.56) weeks, 94.2% ( n =198) were postpartum, and 88.6% ( n =186) were post-caesarean section. Pre-existing cardiac disease (44.3%, n =93), eclampsia and preeclampsia (20%, n =42), obstetric haemorrhage (16.2%, n =34), and pulmonary oedema (6.2%, n =13) were the most common causes of admission. Sixty-one percent ( n =128) of patients received ventilatory support. The median length of ICU stay was 24 hours (range 1 - 17 days). Eighty-seven percent ( n =183) of the patients were haemodynamically stable. Maternal mortality was 9% ( n =19). Conclusion . Cardiac disease in pregnancy was the most common diagnosis in patients admitted to our ICU, followed by eclampsia and preeclampsia. Most of the patients (87.1%) were haemodynamically stable and needed minimal intervention, as confirmed by their short periods of stay in ICU. Although the mortality rate in our institution was higher than that observed in developed countries, it was lower than rates reported in other South African studies. This study has found that many of the patients were admitted to ICU for monitoring purposes only and did not require ICU level of care.","PeriodicalId":75194,"journal":{"name":"The Southern African journal of critical care : the official journal of the Critical Care Society","volume":"7 1","pages":"12-14"},"PeriodicalIF":0.0,"publicationDate":"2017-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84911025","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}

引用次数: 3

Lived experiences of Rwandan ICU nurses caring for patients with a do-not-resuscitate order 卢旺达ICU护士护理不复苏命令患者的生活经验

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2017-07-11 DOI: 10.7196/281

E. Nankundwa, P. Brysiewicz

{"title":"Lived experiences of Rwandan ICU nurses caring for patients with a do-not-resuscitate order","authors":"E. Nankundwa, P. Brysiewicz","doi":"10.7196/281","DOIUrl":"https://doi.org/10.7196/281","url":null,"abstract":"Background. Do not resuscitate (DNR) is the policy and practice of deliberately not attempting to resuscitate a person whose heart has stopped beating. Research on nursing care for patients designated with DNR orders has been conducted since the late 1980s; however, no study appears to have been carried out in the Rwandan setting. Purpose . The purpose of this study was to explore the lived experiences of nurses caring for a patient with a DNR order in an intensive care unit (ICU) in Kigali, Rwanda, in order to suggest nursing recommendations. Methods. Using a phenomenological approach, two semi-structured interviews were conducted with each participant to explore their lived experiences of caring for patients with DNR orders. The sample comprised six nurses from an ICU in a large tertiary-level hospital in Kigali, Rwanda. Results . The data were organised into categories based on a review of the data from the interviews of the six participants. The categories were: feeling emotional distress; barrier to optimal care; and not part of decision-making. Conclusion . DNR orders are a fairly new concept in Rwanda and the practice of DNR orders in ICU is very demanding for the staff, especially the ICU nurses. Additional education about DNR orders as well as policies to guide its implementation could assist ICU nurses in their difficult work.","PeriodicalId":75194,"journal":{"name":"The Southern African journal of critical care : the official journal of the Critical Care Society","volume":"32 1","pages":"19-22"},"PeriodicalIF":0.0,"publicationDate":"2017-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86939151","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}

引用次数: 8

The treatment of autonomic dysfunction in tetanus 破伤风自主神经功能障碍的治疗

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2017-07-11 DOI: 10.7196/SAJCC.2017.V33I1.274

T. V. D. Heever, M. Spruyt

引用次数: 4

Contamination of nebulisers and surrounding air at the bedside of mechanically ventilated patients 机械通气病人床边的雾化器和周围空气的污染

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2017-07-11 DOI: 10.7196/295

L. V. Heerden, H. V. Aswegen, S. V. Vuuren, R. Roos, A. Dusé

{"title":"Contamination of nebulisers and surrounding air at the bedside of mechanically ventilated patients","authors":"L. V. Heerden, H. V. Aswegen, S. V. Vuuren, R. Roos, A. Dusé","doi":"10.7196/295","DOIUrl":"https://doi.org/10.7196/295","url":null,"abstract":"Background . The delivery of aerosolised medication, as performed by nurses and physiotherapists in intensive care units (ICUs), forms an important component of patient care. Objectives. To determine the presence of contamination of nebulisers used within a ventilator circuit; to describe the protocol and clinical practice regarding decontamination and storage of these devices; and to identify micro-organisms colonising contaminated nebulisers and the surrounding air at patients’ bedsides. Methods . A cross-sectional multicentre observational study was conducted, including site and equipment sampling to determine contamination. ICU managers were interviewed to determine the decontamination and storage protocols used for nebulisers in their units. Swabs were taken from nebuliser chambers and streaked onto blood agar plates (BAPs). An air sampler was used to collect air samples from the surrounding bedside environment. The BAPs were incubated for bacterial and fungal contamination. Species of colonies observed in these samples were identified. Results. Sixty-one nebulisers from seven ICUs were sampled (Micro Mist n =37; Aeroneb n =24). Half of the nebulisers (Micro Mist ( n =19, 51.4%));Aeroneb ( n =12, 50%)) and most air samples ( n =60, 98%)) presented with contamination. All participating ICUs reported decontamination and storage protocols, but visual inspection of nebulisers suggested that the protocols were not observed. Nebulisers rinsed with alcohol and left open to the environment to dry had the lowest contamination rates. Coagulase-negative Staphylococcus species (spp.) were mostly found in the surrounding air and Aeroneb samples, and Enterococcus spp. were mostly found in the Micro Mist nebulisers. Conclusion . Although decontamination and storage protocols for nebulisers were in place, nebuliser and air contamination was high, possibly due to poor staff adherence","PeriodicalId":75194,"journal":{"name":"The Southern African journal of critical care : the official journal of the Critical Care Society","volume":"32 1","pages":"23-27"},"PeriodicalIF":0.0,"publicationDate":"2017-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81692737","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}

引用次数: 1

Transportation of blood in a helicopter emergency medical service: The importance of specialised equipment 直升机紧急医疗服务中的血液运输:专用设备的重要性

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2016-11-10 DOI: 10.7196/SAJCC.2016.V32I2.268

Christopher Stein, Eduardo Caetano

{"title":"Transportation of blood in a helicopter emergency medical service: The importance of specialised equipment","authors":"Christopher Stein, Eduardo Caetano","doi":"10.7196/SAJCC.2016.V32I2.268","DOIUrl":"https://doi.org/10.7196/SAJCC.2016.V32I2.268","url":null,"abstract":"Background . Administration of blood in the pre-hospital environment is becoming more feasible, particularly in helicopter emergency medical services (HEMS) during primary response and critical care transfers of major trauma patients. The main challenge in this environment is maintaining a suitable thermal environment for blood transport during missions that may last several hours. Aim . To investigate whether a simple and cost-effective method of storage in a typical HEMS operation would provide an adequate thermal environment for blood. Method . A commercially available cooler box and ice packs were used to simulate a blood transport environment during HEMS missions over three summer and three winter months. In-box temperature was monitored using an electronic thermometer and data logger. Results . Temperature data were recorded during 146 missions with a mean duration of 02:01:35 (95% confidence interval 01:46:25 - 02:16:46). A total of 344 temperature observations were done in the summer months and 384 in the winter months. All mean temperatures recorded in the cooler box were within the required 1 - 6°C range; however, of the total temperature observations recorded, 30% (102/344) during summer were >6°C while 8% (32/384) during winter were >6°C and 15% (59/384) were <1°C. The maximum temperature recorded overall was 13°C and the minimum was −3°C. Conclusion . Low-cost, non-specialised materials used in a HEMS operation were not adequate for the safe transport of blood.","PeriodicalId":75194,"journal":{"name":"The Southern African journal of critical care : the official journal of the Critical Care Society","volume":"37 1","pages":"62-63"},"PeriodicalIF":0.0,"publicationDate":"2016-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81292339","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}

引用次数: 3

The needs of family members of intensive care unit patients : a grounded theory study 重症监护室病人家属的需求:一个接地气的理论研究

The Southern African journal of critical care : the official journal of the Critical Care Society Pub Date : 2016-11-10 DOI: 10.7196/SAJCC.2016.V32I2.298

J. Beer, P. Brysiewicz

{"title":"The needs of family members of intensive care unit patients : a grounded theory study","authors":"J. Beer, P. Brysiewicz","doi":"10.7196/SAJCC.2016.V32I2.298","DOIUrl":"https://doi.org/10.7196/SAJCC.2016.V32I2.298","url":null,"abstract":"Background . The unexpected admission of a loved one to an intensive care unit (ICU) may have a negative effect on the everyday lives of family members, as they have had little time to adjust. Hence, it is imperative for healthcare professionals to promote optimal outcomes for both the patient and family members during admission for critical illness. Objective . To explore and describe the needs of families during critical illness and to develop methods to provide family care during a critical illness of a loved one. Methods . The Strauss and Corbin grounded theory approach was used. In-depth interviews with 16 intensive care nurses, 6 doctors and 9 family members in private and public settings were completed. Results . Five codes emerged using the characteristic coding in grounded theory. These were identified as information sharing; reassurance; striving for consolation; garnering of resources; and cultural and religious co-operation. Conclusion . This study elicited the needs of family members of ICU patients. Methods tailored around these needs were presented to support family members during a critical illness.","PeriodicalId":75194,"journal":{"name":"The Southern African journal of critical care : the official journal of the Critical Care Society","volume":"2 1","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2016-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72855133","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}

引用次数: 21