Analysis of bowel sounds application status for gastrointestinal function monitoring in the intensive care unit.

The auscultation of bowel sounds (BS) has been neglected as a reliable tool for determining gastrointestinal (GI) functioning in the critically ill patient. This article considers the validity of BS auscultation in the assessment and management of critically ill patients and outlines how the information may be utilized for monitoring GI function. A descriptive, cross-sectional design with self-administered questionnaires was used to survey 132 nurses and 38 doctors in the 6 general intensive care units in Beijing hospitals. Descriptive statistics and chi-square test analyses were used to assess the level of knowledge about BS among Chinese doctors and nurses and to determine how they applied their BS auscultation findings in the care of critically ill patients. Bowel sounds were found to be the primary indicator for determining GI functioning in the unconscious, critically ill patient. However, only 11.4% of nurses and 47.6% of doctors could make correct clinical judgments on the basis of their auscultatory findings. The attitudes of nurses and doctors differed significantly on whether BS auscultation was needed to monitor GI function for unconscious patients. Bowel sounds auscultation remains an important indicator of GI function. Distinct and feasible standards regarding BS auscultation and results interpretation need to be established.

Bowel sounds and monitoring gastrointestinal motility in critically ill patients.

PURPOSE: The aims of this study were to determine whether bowel sounds auscultation is necessary in critically ill patients and to forecast the prospect of bowel sounds as a monitoring measurement in the intensive care unit (ICU). BACKGROUND: It has been suggested recently that bowel sounds are not an objective indicator of bowel motility and that auscultation should be abandoned. This has led to confusion as to whether bowel sounds auscultation should be continued in the ICU. DESCRIPTION OF THE PROJECT: A literature review of articles about bowel sounds and monitoring gastrointestinal motility in critically ill patients was conducted. OUTCOME: At present, there are no more suitable indicators for bedside monitoring of bowel function and motility than bowel sounds. Although they lack objectivity, bowel sounds give a lot of useful information about gastrointestinal motility. The problems are how to improve practice and assessment standards and enhance the precision of auscultation devices. CONCLUSION: Bowel sounds auscultation is necessary in the ICU. Effective application in critically ill patients requires reasonable practice and precise instrumentation.

Evaluation of emergency tourniquets for prehospital use in China.

OBJECTIVE: Massive hemorrhage is life-threatening during armed conflicts. Tourniquets are important medical devices used to reduce severe bleeding in trauma. The aim of this study was to empirically evaluate the current tourniquets used in China and provide information to emergency nurses in selecting the appropriate tourniquet. METHODS: Five tourniquets were self-applied by 20 healthy participants. The blood flow distal to the tourniquet site was assessed using vascular Doppler ultrasound. Application time, pain, numbness, and other parameters were evaluated. RESULTS: The bladder tourniquet and windlass tourniquet effectively occluded arterial blood flow with success rates higher than 75% in both the upper and lower extremities. The Cargo-strap was the fastest to apply, taking (7.22+/-2.30) s for the upper extremity and (6.48+/-2.40) s for the lower extremity. The rubber tube was the most painful, and the improvised tourniquet was the least efficient. The success rates were higher in the lower extremity than in the upper extremity (P less than 0.05, X(2) equal to 5.714). CONCLUSIONS: The bladder tourniquet and the windlass tourniquet are efficient tourniquets, although the windlass is superior with respect to portability and pain. The Cargo-strap and rubber tourniquets have several disadvantages that reduce their suitability for field use. The improvised tourniquet is not recommended because of low efficiency and severe pain during implementation.

[Effect of temperature of fluid infusion on diamine oxidase, MB isoenzyme of creatine kinase, creatine-kinase and lactate dehydrogenase in hemorrhagic shock rabbits].

OBJECTIVE: To investigate the effects of different temperatures of fluid infusion on diamine oxidase(DAO), MB isoenzyme of creatine kinase (CK-MB), creatine kinase (CK) and lactate dehydrogenase (LDH) in rabbit with hemorrhagic shock so as to provide a clue to improve the nursing care in patients with hemorrhagic shock. METHODS: An animal model of controlled hemorrhagic shock in rabbits as previously reported was used in this randomized experiment. Twenty-three rabbits were randomized to a warm fluid infusion group (n=8), a ambient-temperature fluid infusion group (n=7), and a cold fluid infusion group (n=8). The rabbits were then resuscitated with Ringer's lactate solution three times of that of blood loss. DAO and values of myocardial enzyme were measured before shock, during shock and 1 hour, 2 hours and 4 hours after fluid infusion, respectively. RESULTS: There was no significant difference in DAO and values of myocardial enzymes among groups, though there was a lower value in DAO and values of myocardial enzymes at 1 hour to 4 hours after warm fluid infusion. CONCLUSION: Our data indicate that warm fluid infusion in rabbit model of controlled hemorrhagic shock has some beneficial effect on some biochemical values. In view of this result, temperature of fluid infusion in nursing care for patients with hemorrhagic shock should pay more attention to.