ICU Nurses and Burnout | Chapter 6 | New Visions in Medicine and Medical Science Vol. 7

This article summarizes existing literature and experiences about the work environment in intensive care units by health professionals especially nurses as they are the constant and major workforce in the health care field. Intensive care units are dedicated sections of hospitals where medical staff members give continuous care and advanced life support around-the-clock. Nurses are considered to be at high risk due to stressful working environments including emergency care, high mortality & morbidity, ethical dilemmas, and pain care causing physical and emotional exhaustion leading to Burnout Syndrome. Although there is a vast literature on burnout among ICU nurses, there is a constant need to investigate emerging risk factors and ways to prevent and manage them. This article aims to discuss regarding working environment the nurses in ICUs are at risk and their solutions at individual, collaborative, and systemic levels which may decline burnout among ICU nurses.

Author(s) Details:

Nikita Saini,
AIIMS, Bhopal, M.P., India.

Please see the link here: https://stm.bookpi.org/NVMMS-V7/article/view/14223

Application of Spike’s Protocol in Emergency and Intensive Care Unit While Delivering Death News to the Patient’s Attendant in a Tertiary Care Hospital in New Delhi, India | Chapter 8 | Advancement and New Understanding in Medical Science Vol. 6

Declaring the news of the death of a loved one is the most difficult and stressful part faced by a healthcare professional. This requires patience, good communication skills, and empathy. The bad news can be delivered in various ways but the most common method used in this study is the SPIKES protocol. The SPIKES protocol is a six-step process used to deliver bad news in a healthcare setup. The aim of this study is to discover the use of SPIKES protocol by healthcare professionals, especially in Emergency rooms and Intensive care units. All the healthcare professionals working in the ER and ICU of the hospital in Max Super Speciality Hospital, Shalimarbagh, New Delhi were included in this study. The study included a total of 100 active participants across the Emergency and ICU departments of the hospital. The major participants were female (68) when compared to male (32). Only 52% of the participants knew about the SPIKES protocol, its application and use and adequate details about it. The study also shows the need for separate counselling rooms to make this procedure smoother and safer for healthcare professionals to avoid any unwanted aggression from the patient's relatives.

Author(s) Details:

Surjeet Acharya,
Max Super Speciality Hospital, Shalimar Bagh, New Delhi, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V6/article/view/13359

Ocular Alterations in Severe COVID-19 Patients with Invasive Mechanical Ventilation and Prolonged Pronation | Chapter 4 | Advancement and New Understanding in Medical Science Vol. 2

This work was designed to investigate ocular alterations in patients affected by severe COVID-19 who required invasive mechanical ventilation and prolonged pronation to optimize lung ventilation areas.

Conjunctivitis seems to be the initial or only symptom of this pathology, other alterations in the ocular surface are chemosis, epiphora and ocular secretions. In the COVID-19 pandemic, the use of intensive care units, prolonged pronation, and invasive mechanical ventilation in the management of complicated patients increased greatly. The study design was descriptive, prospective, and cross-sectional, it was carried out in the Intensive Care Unit of the Specialties Hospital of the XXI Century National Medical Center, Mexican Institute of Social Security during the months of March and May 2021. All patients over 18 years of age, of both sexes with a positive test polymerase chain reaction (PCR) for COVID-19, who had the diagnosis of severe pneumonia associated with SARS-CoV-2 who were under invasive mechanical ventilation and who had more than 16 hours of pronation.

The mean age of the patients was 60 years. 68.9% had comorbidities. The most frequent findings in adnexa were blepharoedema and chemosis. In the ocular fundus, several alterations including cotton-wool lesions, intraretinal hemorrhages and arteriolar vasoconstriction were observed. The effect of the hours of pronation on the frequency of retinal alterations was statistically significant the group of patients without changes against those who had more than two retinal alterations. Having more than 145 hours of pronation increases the risk of having more than two retinal alterations. Intraocular pressure increased in pronation by 61 % with P < 0.05. In COVID-19 pneumonia that causes a critical state, it has been seen that there is a proinflammatory and thrombotic state and tissue ischemia due to decreased oxygen distribution, which is related to the development of multi-organ failure and this in turn.

The ocular alterations in patients with COVID-19 under invasive mechanical ventilation and prolonged pronation range from the ocular adnexa to the alterations in the fundus of the eye.

The relevance of this study lies in the fact that the patients were examined during the most severe period of the disease, where more systemic ischemic alterations could have manifested. These results suggest the need to implement a protocol for the primary and secondary prevention of ocular complications in patients with COVID-19, but which may be useful for patients who must remain in prolonged pronation for other medical indications.

Author(s) Details:

Zaira Lizette Jiménez Díaz,
Ophthalmology Service, Specialties Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

Julio Alejandro Blanco D´Mendieta,
Ophthalmology Service, Specialties Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

Arturo Carrasco Quiroz,
Ophthalmology Service, Specialties Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

Lizbeth Karina Blanco D´Mendieta,
Ophthalmology Service, Specialties Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

José D. Méndez,
Medical Research Unit in Metabolic Diseases, Cardiology Hospital, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13090

Intensive Care Unit Management of Traumatic Brain Injury: From Basics to Practice | Chapter 14 | Current Innovations in Disease and Health Research Vol. 2

 This member highlights the administration of traumatic brain harm in the intensive care unit. Traumatic Brain Injuries (TBIs) are a important source of disability and humanness, which excessively affect reduced- and middle-income countries. The up-to-date management of harsh TBI has fallen into the rule of a multidisciplinary team managed by neurointensivists, neuroanaesthetists, and neurosurgeons and is based on the preventing of secondary injury, perpetuation of cerebral perfusion pressure, and addition of cerebral oxygenation. For the young and unskilled physician, mnemonics have existed demonstrated expected helpful in remembering the methodical care of clinical questions. This contribution attempts to offer the puzzle "HEAD" as a helpful mnemonic for the administration of TBI in the ICU.

Author(s) Details:

K. U. Tobi,
Department of Surgical Sciences, Division of Anaesthesiology, School of Medicine, Hage Geingob Campus, University of Namibia, Windhoek, Republic of Namibia.

O. A. Ogunbiyi,
Critical Care Unit, Mainland Hospital, Yaba, Lagos, Nigeria.

Please see the link here: https://stm.bookpi.org/CIDHR-V2/article/view/11202

Assessment of Mortality Risk Factors in Patients with Severe COVID-19 Acute Respiratory Distress Syndrome | Chapter 15 | New Advances in Medicine and Medical Science Vol. 6

 The aim concerning this study was to identify risk determinants predicting humanness in patients with harsh COVID-19 complicated with ARDS. We particularly tested the friendship of these clinical outcomes accompanying the changes in PaO2/FiO2 ratio (P/F), arterial blood pH the fortification to ground glass opacities percentage (C/ GGO) the Murray lung injury score (MLIS). COVID-19 affliction caused by severe severe respiratory syndrome coronavirus 2 (SARS-CoV-2), that originated in China, has made a global outbreak that has touched more than 70 million society worldwide. . The dispassionate characteristics of COVID-19 survivors and non-survivors ARDS groups were compared clinically, workshop, and radiographically.Results indicated that the median age of non-survivors ARDS sufferers was 68.4 years traditional, which was significantly earlier than those with survivors ARDS by 9,9 years. Male and subjects with BMI>30 were more inclined die from ARDS. The prevalence of fortification (Consolidation\ground glass opacities ratio>1) in alveolus, secondary bacterial contamination, mechanical ventilation and pack beneficial dexamethasone before intubation were common among non-survivors ARDS.The principles of assessing scores (MLIS, Cons/GGO percentage, P/F ratio and SOFA) were changed otherwise. Among non-survivor group these scores were getting decaying by time, and in contrary to these with survivor all these scores were recover and to the end of the 16-th were near usual ranges. Partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) event of admission again was significantly lower compared to survivors ARDS inmates (p<0.05) and arterial blood gas reasoning values were considerably differ: partial pressure of colorless odorless gas (PaCO2) was markedly higher (p=0.023), PaO2 was lower (p=0.026) and acridness of the blood pH was likewise lower (p=0.02).We discovered risk factors for oblivion in ARDS patients with harsh COVID-19. The clinical effects of patients with harsh COVID-19 complicated by ARDS may be jolted by the healthcare providers' use of these verdicts.

Author(s) Details:

Alizamin Sadigov,
Terapeutic Education Clinic, Medical University, Baku City, Azerbaijan.

Malahat Sultanova,
Surgery Education Clinic, Medical University, Baku City, Azerbaijan.

Emil Gasimov,
New Hospital, Baku City, Azerbaijan.

Gunel Sadigova,
Terapeutic Education Clinic, Medical University, Baku City, Azerbaijan.

Sharaf Huseynova,
Healthcare Center of Baku, Baku City, Azerbaijan.

Cavid Pashayev,
Baku Medical Center, Baku City, Azerbaijan.

Please see the link here: https://stm.bookpi.org/NAMMS-V6/article/view/10996

Could FXIII Deficiency Influence Intracerebral Hemorrhage after Neurosurgery? | Chapter 9 | Current Practice in Medical Science Vol. 8

The main objective was to determine how perioperative FXIII levels affected ICH following brain surgery. An 18-month prospective observational study was conducted at a Spanish third-level hospital. It comprised all consecutive adults (18 years or older) who underwent elective brain tumour surgery and underwent postoperative care in the Neurointensive Care Unit (N-ICU). Ages under 18, informed refusals, deaths in operating rooms, inadequate blood samples, and non-tumor tissue were prohibited. FXIII levels in three blood samples were measured (A-presurgical, B-postsurgical and C-24 hours after surgery). The study involved 109 patients. Final ICH confirmation was made in 39 of them (35,78 percent). An association between the length of the ICU stay (p0,01) and the male gender (p0,03) and the ICH was found by inferential studies. Particularly in the B sample, ICH patients' average FXIII was lower (A 71,2 percent, B 51,57 percent, C 52,14 percent). After brain tumour surgery, acquired FXIIID (70%) elevated ICH, indicating that it might be employed as a risk marker for haemorrhage. Additionally, male gender, baseline variation, and a longer ICU stay were all associated with ICH. Tests for normal coagulation did not exclude FXIII disease. Future research may focus on FXIIID detection and replacement therapy as a therapeutic goal.

 

Author (s) Details

Estela Val Jordan

Department of Critical Care, Hospital Universitario Miguel Servet, Paseo Isabel La Católica, 1-3. 50009, Zaragoza, Spain.

 

Please see the link here:- https://stm.bookpi.org/CPMS-V8/article/view/7798

Assessment of Antibiotic Sensitivity Pattern of Bacterial Isolates in the Intensive Care Unit of a Tertiary Care Hospital in Eastern India| Chapter 9 | Issues and Developments in Medicine and Medical Research Vol.10

 Background: Nosocomial infections are a primary cause of morbidity and mortality in hospitalised patients, particularly critically sick patients in the intensive care unit (ICU), where a large number of medications are provided, resulting in the development of antibiotic-resistant microorganisms.

The study's goal was to determine the prevalence of common bacterial germs, as well as their medication sensitivity and resistance, in the ICU of an Eastern Indian teaching hospital.

A retrospective record-based study was conducted in the ICU of Hi- Tech Medical College and Hospital in Odisha, Eastern India, from November 2011 to October 2012. Patients who were clinically suspected of contracting an infection within 48 hours of being admitted to the ICUs were included in the study. Patients' clinically suspected laboratory samples were gathered and antibiotic sensitivity was assessed.

The rate of nosocomial infection was found to be 28.2 percent. Urinary tract infection was the most prevalent infection (54.9 percent). E. coli was the most prevalent isolate (52.7%), followed by P. mirabilis (15.4%) and Ps aeruginosa (14.4%). (13.2 percent). E. coli was very susceptible to Polymyxin B, Gatifloxacin, and Ceftriaxone, whereas it was highly resistant to Cephalexin, Cefadroxil, Tobramycin, and Prulifloxacin.

Conclusions: Resistance to third-generation cephalosporins and aminoglycosides was found in the majority of the bacterial isolates. Antibiotic susceptibility patterns must be monitored on a regular basis, and antibiotics must be used wisely to reduce nosocomial infection rates and antimicrobial resistance.

Author(s) Details:

Prof. Chaitali Pattanayak,
Department of Pharmacology, Kalinga Institute of Medical Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India.

Dr. Sunil K. Patanaik,
Department of Surgery, Kalinga Institute of Medical Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India.

Dr. Pratyay Pratim Datta,
West Bengal Health Service, India.

Prof. Parbaty Panda,
Department of Pharmacology, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India.

Please see the link here: https://stm.bookpi.org/IDMMR-V10/article/view/5823

Determination of Measurement Plan: ICU Nurses’ Challenges in Implementing a Pain Assessment Tool with Adult Nonverbal Patients | Chapter 06 | Issues and Developments in Medicine and Medical Research Vol. 7

 The data was collected using a measurement plan approach, as well as the designated data sources. These are elements of the measuring strategy used for a project. The overarching goal of the quality improvement project's measurement strategy is to find out how difficult it is for nurses to conduct pain assessments in the Intensive Care Unit (ICU) with a patient who is unable to self-report. A measurement strategy, which addresses and develops a proper technique of assessing patient pain in the ICU, is an important aspect of the improvement effort. The idea is to use the pain assessment tool to assist nurses in assessing the suffering of nonverbal patients, rather than forcing nurses to use something they don't believe in. The technology should assist ICU nurses in accurately assessing patients' discomfort while without adding to their workload.

Author(S) Details

Shahad Faisal Halabi
University of Nottingham, UK.

View Book:- https://stm.bookpi.org/IDMMR-V7/article/view/5761