effects of expiratory rib cage compression before endotracheal suctioning on arterial blood gases in patients under mechanical ventilation

Endotracheal suctioning is one of the most frequently used methods for airway clearance in patients under mechanical ventilation. Chest physiotherapy techniques such as expiratory rib cage compression before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretions and improving alveolar ventilation. This study was carried out to determine the effects of expiratory rib cage compression before endotracheal suctioning on arterial blood gases in patients mechanically ventilated patients. This research was a clinical trial study with a crossover design. The subjects consisted of 70 [35 females, 35 males] mechanically ventilated patients who were admitted to medical and surgical intensive care units and emergency department of Hazrat- Rasool Hospital in Tehran. Subjects were selected with consecutive sampling. The patients received endotracheal suctioning with and without rib cage compression, with a minimum 3- hours interval between the two interventions. Expiratory rib cage compression was performed for 5 minutes before endotracheal suctioning. Arterial blood gases were measured 5 minutes before and 25 minutes after endotracheal suctioning. Data were recorded on the data recording sheet. Data were analyzed using Wilcoxon and paired t-tests. There were a statistically significant differences in the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen [Pao2/Fio2], Paco2, and arterial oxygen saturation [Sao2] between before and after endotracheal suctioning in both methods [endotracheal suctioning with and without rib cage compression] [p=0.000]. Moreover, there were statistically significant differences in the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen [P=0.000], Paco2 [P=0.048], and arterial oxygen saturation [P=0.000] between the two methods. Findings showed that expiratory rib cage compression before endotracheal suctioning improves arterial blood gases exchanges in patients under mechanical ventilation, so, performing expiratory rib cage compression before endotracheal suctioning in these patients is recommended

Effect of Education by Visual Compact Disc on Two time- period of Pre-operation Anxiety of Patients who were Candidates for Coronary Artery Bypass Graft [CABG]

Today, arthrosclerosis of coronary arteries is one of the most common life threatening diseases in patients. In fact, Coronary Artery Bypass [CABG] is high risk surgery in both developed and developing countries and heart is a vital organ that is susceptible for any disorders which could be life theatening, because of undergoing CABG patients with high anxiety and stress. Due to surgery anxiety, heart rate, cardiac output and oxygen demand will rise. Then any attempt to decrease patients' preoperational anxiety would be beneficial. One of the efforts to decrease the anxiety level is patient education. There are different viewpoints about educational methods in the literature. This study was a randomized clinical trial with the purpose of determination of the effect of education with visual compact disc [VCD] on the patients' anxiety at the first day and sixth day of admission. Sixty patients were included, 30 were assigned into experimental group and 30 subjects into control group. Sampling method was consecutive. The Spielbergers' questionnaire was used for data collection pre and post educational intervention. The result indicated that the late trait anxiety level significantly decreased in the experimental group compared to the control group at the 6th day before CABG [t=3.79, P=0.001] [t=4.53, P=0.00] respectively. According to the study results, use of visual information by VCD at sixth day before surgery was more effective in clinical setting that the first day. Therefore, nurses can use this educational cost-effective beneficial intervention, for reducing the patients' anxiety

[ educational needs at time of hospital discharge of patients who have undergone coronary artery bypass graft [CABG]]

Patients education should be done according to assessment and determination of their educational needs and their gender. The purpose of this study was to determine and compare educational needs from the view point of men and women with coronary artery bypass at discharge time. This was a descriptive-comparative study. Questionnaire was used to determine the educational needs of 100 men and 100 women who had undergone CABG for the first time in six domains [activity, medication, diet, treatment and complication, enhancing quality of life and skin care] and then compared the results. The findings showed that the immediate educational needs of patients were information"about their activity while the least important mens' need was information about improving quality of life and for women it was information about diet. Findings showed that there was a significant difference"between mens'and womens'educational needs except medication [P<0.0001]. Accordings to the results of this research there was a significant difference between"mens'and womens'educational needs, therefore attention should be paid to the specific educational requirements of different genders."So it is highly recommended that the educational needs of men and women are determined and adequate and proper education should be given to them at the time of discharge