RESUMO
Review three major technological advances in cardiac care: brachytherapy for coronary artery disease, amiodarone for cardiac arrest, and transmyocardial revascularization.
Assuntos
Amiodarona/uso terapêutico , Antiarrítmicos/uso terapêutico , Braquiterapia/métodos , Cardiopatias/terapia , Revascularização Miocárdica/métodos , Humanos , Terapia a Laser/métodos , Guias de Prática Clínica como Assunto , Resultado do TratamentoRESUMO
Learn how to take a team approach to managing your patient's asthma. Strategies focus on preventing acute attacks, relieving acute attacks when they occur, and preventing complications.
Assuntos
Asma/terapia , Doença Aguda , Adulto , Algoritmos , Antiasmáticos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Asma/diagnóstico , Asma/etiologia , Broncodilatadores/uso terapêutico , Criança , Árvores de Decisões , Tratamento de Emergência/métodos , Tratamento de Emergência/enfermagem , Feminino , Humanos , Papel do Profissional de Enfermagem , Avaliação em Enfermagem/métodos , Educação de Pacientes como Assunto , Seleção de Pacientes , Pico do Fluxo Expiratório , Recidiva , Fatores de Risco , AutocuidadoRESUMO
A common cause of emergency department visits, asthma is on the rise. Find out how to keep patients breathing easy.
Assuntos
Asma/enfermagem , Cuidados Críticos/métodos , Avaliação em Enfermagem , Asma/epidemiologia , Asma/fisiopatologia , Asma/terapia , Serviço Hospitalar de Emergência , HumanosAssuntos
Asma/diagnóstico , Asma/terapia , Tratamento de Emergência/métodos , Tratamento de Emergência/enfermagem , Doença Aguda , Adulto , Algoritmos , Asma/epidemiologia , Asma/etiologia , Criança , Árvores de Decisões , Feminino , Humanos , Avaliação em Enfermagem , Equipe de Assistência ao PacienteRESUMO
BACKGROUND: Cardiac catheterization is a common procedure that involves the introduction of a small sheath (5F-8F) into the femoral artery for insertion of other diagnostic catheters. After cardiac catheterization, local compression of the femoral artery is required to prevent bleeding and to achieve hemostasis. Traditional methods of achieving hemostasis require significant time and close supervision by medical personnel and can contribute to patients' discomfort. VasoSeal is a recently developed device that delivers absorbable collagen into the supra-arterial space to promote hemostasis. OBJECTIVES: To compare outcomes between patients receiving a collagen plug and patients in whom a traditional method of achieving hemostasis was used after diagnostic cardiac catheterization. METHODS: An outcomes tracking tool was used to analyze the medical records of 95 patients in whom a traditional method was used (traditional group) and 81 patients in whom VasoSeal was used (device group) to achieve hemostasis. Complications at the femoral access site, patients' satisfaction, and times to hemostasis, ambulation, and discharge were compared. RESULTS: Hematomas of 6-cm diameter occurred in 5.3% of the traditional group; no complications occurred in the device group. The device group also achieved hemostasis faster and had earlier ambulation (P < .001). Patients in the device group were discharged a mean of 5 hours sooner than patients in the traditional group (P < .05). No significant differences were found in patients' satisfaction. CONCLUSIONS: VasoSeal is a safe and effective method of achieving hemostasis after cardiac catheterization that can hasten time to hemostasis, ambulation, and discharge.
Assuntos
Cateterismo Cardíaco , Artéria Femoral , Técnicas Hemostáticas/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Colágeno/administração & dosagem , Equipamentos e Provisões , Feminino , Hematoma/etiologia , Técnicas Hemostáticas/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , PressãoRESUMO
Accurate recognition of signs and symptoms and prompt diagnosis of myocardial infarction are essential for preserving myocardial function and saving lives. However, measurements of cardiac enzymes such as creatine kinase, lactate dehydrogenase, and their isoenzymes do not always provide accurate clinical diagnosis, particularly in patients with other concomitant diseases. Recently, alternative biomarkers of cardiac disease have been described: creatine kinase mass, cardiac troponins, and myoglobin. All cardiac biomarkers have some clinical usefulness in diagnosing acute coronary syndrome and acute myocardial infarction. Indications for use vary for each biomarker, and each has advantages and disadvantages and can be used at various times. However, the following must be considered: (1) Serial testing is essential with any biomarker. (2) None of the current biomarkers can be used to detect myocardial ischemia. (3) The decision of which biomarker to use should be based on the capabilities of the healthcare facility and the signs and symptoms of the patient.
Assuntos
Biomarcadores/sangue , Creatina Quinase/sangue , L-Lactato Desidrogenase/sangue , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/enzimologia , Mioglobina/sangue , Troponina/sangue , Humanos , Isoenzimas , Isquemia Miocárdica/sangue , Seleção de Pacientes , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Social support expected, discrepancies in support (differences between support expected and received), and self-esteem were used to predict emotional (tension and depression) and functional outcomes (recreation, housework, and social life) in a sample of women who had coronary artery bypass surgery (N = 86). Women were interviewed before hospital discharge (T1) and 1 (T2) and 3 (T3) months later. Higher self-esteem was associated with lower depression and tension (T3) and less disruption in social interaction (T2 and T3) and recreation (T3). Results suggest that social support may influence outcomes through enhancement of self-esteem. Directions for further study are given.
Assuntos
Adaptação Psicológica , Ponte de Artéria Coronária/psicologia , Ajustamento Social , Apoio Social , Saúde da Mulher , Atividades Cotidianas , Emoções , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-IdadeRESUMO
In this longitudinal study of women after CABS, the women were coping admirably with good psychosocial and functional outcomes up to 3 months postoperatively. It is suggested that women be instructed how to find and use their support systems and be told that most women do well and return to normal activities of daily living after CABS.
