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Sepsis signposts: Can you spot them?
Sepsis. The word strikes fear into the heart of any nurse—or these days, viewers of certain TV shows. On one episode of the NBC series ER, staffers discussed early goal-directed therapy for a se...
Sepsis: Stopping an insidious killer
A woman, age 65, is admitted to the hospital with a hip infection after hip replacement surgery. The infection, caused by Staphylococcus aureus, has been difficult to treat, so she’s admitted fo...
Infants in peril: Assessing sepsis in newborns
Baby Ryan is delivered vaginally, 11 hours after premature rupture of the membranes. Although 1 week premature, he appears healthy and is breathing without distress. His 1-minute and 5-minute Apgar sc...
Stemming a lethal immunologic response references
Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303-1310.
Cu...
Hospital-acquired infections mortalities, costs
Two common conditions caused by hospital-acquired infections killed 48,000 people and ramped up health care costs by $8.1 billion in 2006 alone, according to a study released Feb. 22 in the Archives o...
Save a life-wash your hands
Did you grow up with your mother insisting you wash your hands? She was right! As nurses, we all know that the simple act of washing our hands saves lives—and that contaminated hands mean nosoco...
Stemming a lethal immunologic response
AFTER EXPERIENCING VOMITING and diarrhea for the past day, Katherine Astley, age 52, visits her primary care provider. The physician finds the patient’s vital signs stable and sends her home with inst...
Little Progress in fight against health care-associated infections, says AHRQ
Most health care-associated infections continue to increase, according to the 2009 National Healthcare Quality Report and National Healthcare Disparities Report issued by the U.S. Department of Health...
Take Note - March 2008
Updated guidelines on end-of-life care To improve the quality of palliative end-of-life care, the American College of Physicians has revised its guidelines. According to the new recommendat...
Formula for success: Deliver enteral nutrition using best practices
Appearing poorly nourished, Louis Marshall, age 68, is admitted to the hospital with decreased mental status. He has a history of alcoholism and has been drinking heavily since losing his job several ...
Catching on to C. difficle
Move over, MRSA. Clostridium difficile is fast becoming a rampant hospital infection. A gram-positive, spore-forming, anaerobic bacillus, C. difficile is now the most common cause of antibiotic-associ...
Prevailing over acute pancreatitis
An inflammatory condition, acute pancreatitis runs the gamut from mild to severe. In the United States, it accounts for about 150,000 to 225,000 hospital admissions each year, at an estimated cost of ...
Buying time for patients with acute liver failure
In the United States, about 2,000 people a year suffer acute liver failure. That doesn’t sound like a big number, but of those 2,000 people, 30% to 50% will die from complications. Those are big...
CRRT spells success against acute renal failure in critically ill patients
Acute renal failure (ARF) has become more complex than it used to be. Decades ago when hemodialysis was first used regularly in the intensive care unit (ICU), most ARF patients had uncomplicated end-s...
Drugs Today - December 2008
First drug in new antiretroviral class blocks host-cell receptor in HIV In two large phase 3 trials, maraviroc (Selzentry) significantly suppressed human immunodeficiency virus (HIV) and l...
Letters to the Editor - November 2007
A timely expression of support “Being with dying” in the September issue was timely for my staff and me. I am an RN Unit manager for a 46-bed dementia unit in a 166-bed long-term care f...
Taking the ICU to the Patient
You’d think the survival rate for in-hospital cardiac arrest would be better than 20%. After all, cardiac arrest is predictable: Most patients show well-known warning signs 6 to 8 hours before a...
Complete blood count: Getting beyond the basics
If you look at a complete blood count (CBC) only for blood cell counts, platelet counts, and hemoglobin and hematocrit values, you need to take another look. A CBC—especially the red blood cell ...
Getting the message out: Older adults need oral care
Despite its link to overall health, older adults often do not get the proper oral health care they need.
“Affordable, accessible preventive care, including oral health care, is essential to people ...
Using antibiotics effectively for acute-care patients
No matter where you practice, you’ll frequently find yourself caring for patients receiving antibiotic drugs. Infection is a common problem in all patient populations, and fever or suspected inf...
Are you an ABG ace?
A crucial tool that helps you recognize life-threatening conditions, arterial blood gas (ABG) analysis reveals your patient’s acid-base status and yields important information about pulmonary ga...
Preventing the high-pressure complications of abdominal compartment syndrome
Mike Cannon, age 57, is admitted to the intensive care unit (ICU) with septic shock from pyelonephritis and undergoes aggressive early sepsis resuscitation. After 6 hours, he has received 10 L of...
Overcoming obstacles to vaccination
Today, many of the diseases that in past decades killed or sickened millions of people across the globe have faded from public memory. Many Americans—even many healthcare providers—donR...
The five P's spell positive outcomes for ARDS patients
In the United States, patients with acute respiratory distress syndrome (ARDS) occupy 1 in 10 critical care beds. Each year, ARDS kills 150,000 Americans. Most of the deaths are triggered by an event,...
"Bundle" up to prevent pressure ulcers
Pressure ulcers aren’t always simple wounds that eventually heal with the right treatment. They can have devastating effects on the quality of life for both patients and their families. What’s worse, ...