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CRNA : the clinical forum for nurse anesthetists最新文献

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Management of chronic and acute pain. 慢性和急性疼痛的管理。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-08-01
R A Gauthier
{"title":"Management of chronic and acute pain.","authors":"R A Gauthier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pain management presents exciting opportunities for nurse anesthetists. Today there are thousands of pain clinics and pain services dedicated to the diagnosis and treatment of chronic and acute pain. By becoming familiar with the principles involved in the management of chronic and acute pain, the different treatment modalities available, and the organization of pain clinics and pain services, nurse anesthetists will be able to take advantage of the opportunities they provide.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 3","pages":"90-3"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20253477","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: 0
Clinical differentiation of the patient in pain: an introductory guideline for CRNAs. 疼痛患者的临床鉴别:crna的介绍性指南
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-08-01
J L Loach
{"title":"Clinical differentiation of the patient in pain: an introductory guideline for CRNAs.","authors":"J L Loach","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although the foundation of the specialty of anesthesiology is the treatment of pain, most CRNA practitioners are more focused on and competent in the maintenance of physiological dynamics than in the evaluation and treatment of pain. A lexicon and an established model based on the integration of pathology and pain behavior are discussed, and their mutual use is suggested for evaluation and treatment orientation.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 3","pages":"105-9"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20253480","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: 0
Preemptive analgesia. 先发制人的镇痛。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-08-01
D C Pederson
{"title":"Preemptive analgesia.","authors":"D C Pederson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Preemptive analgesia has recently been the subject of much discussion in the literature including a recent editorial which describes some of the difficulties surrounding the subject. The concept of preemptive analgesia is frequently misunderstood by anesthesia providers especially relative to the use of regional anesthesia. This confusion hampers anesthetists in their practice when they seek to provide optimal pain care for their patients, and especially when regional block is not an option in their particular practice or is inappropriate either for the individual patient or for the surgery being undertaken. This article attempts to differentiate preemptive analgesia from regional anesthetic blockade, and discusses other interventions which may also play a role in producing some measure of preemptive effect.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 3","pages":"110-3"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20253481","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: 0
The occurrence of pain. 疼痛的发生。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-08-01
W E Ellis
{"title":"The occurrence of pain.","authors":"W E Ellis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anesthesia practitioners provide pain relief during surgery and in the immediate postoperative period. As a result of this intervention, anesthesia practitioners and surgeons share concern for and interest in relieving the patient's painful experiences. When pain is minimized, the patient is willing to ambulate and institute self-care with gentle encouragement. As patients are increasingly able to care for themselves, recovery is accelerated both in the hospital and at home. However, an entire population group is underdiagnosed and undertreated for pain-they are the elderly, especially those who receive institutional care. One of the major difficulties with this group of individuals is the availability of an accurate and dependable evaluation tool to ascertain the presence and acuity of the pain present.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 3","pages":"101-4"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20253479","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: 0
Use of propofol in patients with Parkinson's disease: report of a case. 异丙酚在帕金森病患者中的应用:1例报告。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-08-01
C C Dewey
{"title":"Use of propofol in patients with Parkinson's disease: report of a case.","authors":"C C Dewey","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 3","pages":"114-5"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20253482","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: 0
Acute pain management clinical practice guideline: implications for nurse anesthetists. 急性疼痛管理临床实践指南:对护士麻醉师的启示。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-08-01
L Heindel
{"title":"Acute pain management clinical practice guideline: implications for nurse anesthetists.","authors":"L Heindel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Millions of operative procedures are performed in the United States each year. One of the greatest concerns for the surgical patient is postoperative pain. Despite traditional efforts to alleviate this pain, clinical studies indicate that postoperative pain is not relieved in most patients. The federal Agency for Health Care Policy and Research (AHCPR) developed a clinical practice guideline, Acute Pain Management: Operative or Medical Procedures and Trauma to help clinicians, patients, and patient's families understand the assessment and treatment of postoperative acute pain in both adults and children. Certified registered nurse anesthetists (CRNAs) can use the guideline to improve acute pain management within their institutions. Effective pain management can be accomplished through a collaborative, interdisciplinary approach using an individualized proactive pain control plan. Frequent assessment and reassessment of pain, use of drug and nondrug therapies, and implementation of an institution-wide program using CQI/QA methods in necessary. Implications for CRNAs include providing patient and staff education, establishing standards of care for pain management, and adapting an aggressive \"no pain, much gained\" clinical practice.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 3","pages":"94-100"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20253478","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: 0
Anesthetic drug interactions. 麻醉药物的相互作用。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-08-01
M S McAuliffe, E A Hartshorn
{"title":"Anesthetic drug interactions.","authors":"M S McAuliffe,&nbsp;E A Hartshorn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 3","pages":"116-20"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20253483","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: 0
Cost effectiveness of blood transfusions: risk and benefit. 输血的成本效益:风险与效益。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-05-01
D H Gleason, B J Leone
{"title":"Cost effectiveness of blood transfusions: risk and benefit.","authors":"D H Gleason,&nbsp;B J Leone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Allogenic blood transfusion carries the remote but well-known risk of disease transmission. The advent of an all-volunteer donor pool and modern screening techniques have made the blood supply the safest it has ever been. Despite these advances, however, clerical errors are still a cause of transfusion morbidity. Less well defined are the effects of allogenic blood on immunosuppression with resultant increase in infections and tumor recurrence. Strategies to reduce the need for allogenic blood include autologous predonation, acute normovolemic hemodilution perioperatively, and the salvage of shed blood. Autologus predonation eliminates many disease risks while keeping costs at least comparable to allogenic blood. Acute normovolemic hemodilution offers the advantage of low cost and the use of autologus fresh blood at the end of the operation. In the future, artificial blood substitutes now undergoing clinical trials, may play an important role in reducing the need for allogenic transfusions. Two promising agents are hemoglobin-based oxygen carriers and perfluorocarbons. Both offer the advantage of long shelf life and eliminate the need for crossmatching, but they are limited by short half-life.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 2","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"1997-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20243855","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: 0
Financing nurse anesthesia education. 资助护士麻醉教育。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-05-01
S M Ouellette
{"title":"Financing nurse anesthesia education.","authors":"S M Ouellette","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Health care spending in the United States outpaces all other nations or 14% of the gross domestic product. Although the escalating increases in health care costs which have characterized the industry over the past quarter century have begun to slow down, if changes in the current health care policy are not implemented, spending is expected to increase at a rate of 11.5% during each of the next 5 years. Health care spending will reach $1.1 trillion or 15% of the gross domestic product in the near future. Both hospitals and universities are facing mounting pressures to reduce their costs and improve their services. In this environment, it becomes increasingly important for directors of nurse anesthesia programs to financially justify their existence. This discussion begins with a brief overview of nurse anesthesia education in the United States. The value of and need for nurse anesthetists in the US health care system is addressed. Advantages and disadvantages of hospital versus university-based programs are highlighted and funding sources identified. Future needs and challenges in nurse anesthesia education conclude this discussion.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 2","pages":"62-8"},"PeriodicalIF":0.0,"publicationDate":"1997-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20243854","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: 0
The practice and distribution of Certified Registered Nurse Anesthetists in federally designated nurse shortage areas. 在联邦指定的护士短缺地区注册护士麻醉师的实践和分布。
CRNA : the clinical forum for nurse anesthetists Pub Date : 1997-05-01
M D Fallacaro
{"title":"The practice and distribution of Certified Registered Nurse Anesthetists in federally designated nurse shortage areas.","authors":"M D Fallacaro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Certified Registered Nurse Anesthetists (CRNAs) provide the majority of clinical anesthesia services to underserved populations in rural America. The United States Office of Shortage Designation, Bureau of Primary Health Care, has compiled a list of counties in the United States with a shortage of nurses. This study examines the distribution of CRNAs within these predominantly nonmetropolitan areas employing the Department of Agriculture's Rural-Urban Continuum classification system. Findings indicate a shortage of CRNAs in designated nurse shortage areas, and demographic characteristics of these practitioners hint at incentives and disincentives for nurse anesthesia clinical practice in rural areas.</p>","PeriodicalId":77087,"journal":{"name":"CRNA : the clinical forum for nurse anesthetists","volume":"8 2","pages":"55-61"},"PeriodicalIF":0.0,"publicationDate":"1997-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20243853","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: 0
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