RESUMO
Traumatic brain injury affects more than 1 million civilians annually. Functional outcomes in this population are less than favorable. This case report describes a patient with a penetrating injury to the head and brain from a gunshot wound including the pathophysiology of injury and outlines evidence-based management guidelines to provide comprehensive care.
Assuntos
Cuidados Críticos , Traumatismos Cranianos Penetrantes/enfermagem , Ferimentos por Arma de Fogo/enfermagem , Enfermagem Baseada em Evidências , Feminino , Traumatismos Cranianos Penetrantes/fisiopatologia , Humanos , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Ferimentos por Arma de Fogo/fisiopatologiaRESUMO
Insertion of pulmonary artery catheters by organ procurement coordinators may be incorporated into donor management to optimize organ perfusion. As invasive procedures are added to coordinator roles, the organ procurement organization must include didactic instruction and supervised clinical experience as part of any training program. Policies and procedures guiding the use of the pulmonary artery catheter and the measurements obtained must be provided by the organization to guide practitioners. This article focuses on methods for insertion and basic troubleshooting of a pulmonary artery catheter.
Assuntos
Cateterismo de Swan-Ganz/métodos , Monitorização Fisiológica/métodos , Coleta de Tecidos e Órgãos , Gasometria , Débito Cardíaco , Cateterismo de Swan-Ganz/efeitos adversos , Cateterismo de Swan-Ganz/instrumentação , Cateteres de Demora/efeitos adversos , Cateteres de Demora/provisão & distribuição , Pressão Venosa Central , Competência Clínica , Desenho de Equipamento , Falha de Equipamento , Medicina Baseada em Evidências , Humanos , Manutenção , Oximetria/métodos , Guias de Prática Clínica como Assunto , Pressão Propulsora Pulmonar , Termodiluição/métodos , Coleta de Tecidos e Órgãos/efeitos adversos , Coleta de Tecidos e Órgãos/métodos , Resistência VascularRESUMO
Placement of central venous catheters by organ procurement coordinators to assist in obtaining blood samples or for measuring intravascular pressure is appropriate. Preparation for this role should include appropriate didactic instruction and supervised clinical experience. The organ procurement organization must ensure that such training occurs and must support a continuing quality assurance program for such providers. Policies and procedures must be provided to guide practitioners in site selection, timing of implementation, and titration of measurements obtained. Also, resources must be readily available to treat any complications. This discussion reviews methods for insertion of venous catheters placed in the femoral, internal jugular, or subclavian veins.
