ABSTRACT
Although technology exists to sustain vital functions of almost any patient, not every pulse-less patient is a candidate for resuscitation. Criteria needs to be developed to guide health care professionals in identifying DNR situations and teaching families about DNR options. The first step is to identify characteristics that are related to current DNR selection, so prescriptive criteria can be developed to aid in DNR decisions in the future. This article presents a descriptive study of characteristics associated with DNR statistics for pediatric ICU patients.
Subject(s)
Family , Intensive Care Units, Pediatric , Medical Futility , Patient Selection , Resuscitation Orders , Adolescent , Child , Child, Preschool , Control Groups , Family/psychology , Female , Humans , Infant , Infant, Newborn , Male , Nurse's Role , Pediatric Nursing , Risk Assessment , Severity of Illness Index , Withholding TreatmentABSTRACT
Fluorescein diacetate (FDA) hydrolysis was evaluated as a means to detect actively metabolizing bacteria in freshwater. Fluorescein diacetate, a nonfluorescent derivative of fluorescein, can be transported across cell membranes and deacetylated by nonspecific esterases. Resultant fluorescein accumulates within cells and allows direct visualization by epifluorescent microscopy. Application of FDA to a variety of freshwater habitats yielded estimates of active cells ranging from 6-24% of the total population. These estimates were 49-61% lower than estimates of active cells obtained from measures of electron transport activity. The difference was attributed to low permeability of the fluorogen through the outer membrane of heterotrophic gram-negative cells. Data suggest that FDA hydrolysis as a means of detecting active bacteria may be limited to environments rich in eucaryotes and gram-positive cells.
