Critical Care

Recognizing risk for increased intracranial pressure

Mary Meyer, a 20-year-old college student, is admitted to the medical unit with flulike symptoms including nausea, vomiting, headache, and fever. Her neck is stiff and sore. She reports feeling increasingly ill over the...

In-bed cycling safe for ICU patients

In-bed cycling starting within the first 4 days of mechanical ventilation is safe and feasible for ICU patients who are hemodynamically stable, according to a study in PLOSOne. Read more

Family satisfaction with ICU care

Emotional/interrelational aspects of care are integral to family member satisfaction with care provided in an intensive care unit (ICU), reports a study in Nursing Research. Read more
ICU

Implementing a mobility program for ICU patients

More than 5 million patients are admitted to intensive care units (ICUs) every year, with survival rates approaching 80%. But when they leave the ICU, many patients experience muscle weakness from bed rest and...

What works: An ED goes vertical to improve patient flow and satisfaction

In the midst of unprecedented change in health care, hospitals and emergency departments (EDs) are attempting the impossible — increase both patient volume and satisfaction without increasing the budget. My hospital is a busy 329-bed,...
hyponatremia

Recognizing acute hyponatremia

Sam Johansen, age 42, is admitted to the medical-surgical unit after 3 days of acute nausea, vomiting, and watery diarrhea associated with acute abdominal pain. His nurse, Megan, obtains initial vital signs: blood pressure...

New guidelines for resolving decision conflicts in the ICU

The American Thoracic Society has released “An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units.” Read more.
chest tubes

Managing chest tubes: Air leaks and unplanned tube removal

Once treated only in high-acuity settings, patients with chest tubes now receive care in inpatient medical-surgical floors, outpatient procedural areas (such as interventional radiology), and other settings. More recently, to help shorten hospital stays...
Excessive opioids

Excessive opioids lead to a close call for a burn patient

Tim Waters, age 28, is admitted to a burn intensive care unit for treatment after a natural gas explosion in his home causes deep partial- and full-thickness burns to 20% of his body surface...
Hypertensive

Responding to a hypertensive crisis

Clifton Jones, an African-American male aged 59, comes to the emergency department (ED) complaining of headache and blurred vision. After the triage nurse measures his blood pressure (BP) at 190/125 mm Hg in the...

Website traffic may help predict ED visits

A study in Annals of Emergency Medicine reported that the number visits to the Stockholm Health Care Guide (a website used by the public to obtain health information) between 6 pm and midnight significantly...

Stroke in a child with sickle cell anemia

Adrienne Johnson, age 5, is admitted to the general pediatric unit. She has sickle cell anemia (hemoglobin SS subtype) and recently was discharged after being hospitalized for acute chest syndrome. According to her mother,...

ICU Diary: The Gift of Care™

As an ICU nurse you’ve probably encountered the critically ill patient who is experiencing hallucinations, delusions, and confusion. Healthcare providers are learning just how detrimental this state of mind can be to the patient’s...