Intrapleural chest drainage.

Abnormal fluid or air between the pleura results in respiratory distress and can cause death, if untreated. Intrapleural chest drains are used to remove abnormal accumulations of fluid or air. Caring for patients with intrapleural chest drains requires knowledge and skill to ensure patient safety. This article describes the pathophysiology, treatment and nursing care of patients who require intrapleural chest drains.

Introduction to electrocardiogram interpretation: part 2.

Twelve-lead electrocardiograms (ECGs) record 12 different views of cardiac electrical activity, or leads. They therefore provide more information than bedside monitors, which usually record one or sometimes two leads. Many acutely ill patients have 12-lead ECGs recorded either on admission to hospital, before undergoing operations or when specific cardiac concerns have arisen. Traditionally, ECGs have aided clinical diagnoses and, by learning how to understand and interpret them, nurses will know when they need to summon expert help. This article describes what each of the 12 leads represents, outlines the main indications for recording 12-lead ECGs and identifies likely causes of error in interpreting them.

An introduction to electrocardiogram interpretation: part 1.

This article describes how to interpret the single-lead electrocardiogram (ECG). The author also describes cardiac electrophysiology and how this is represented by ECG graphs. Part 2 of this article, to be published in the next issue, will describe 12-lead ECGs and acute coronary syndromes.

An introduction to electrocardiogram interpretation: Part 1.

This article describes how to interpret the single-lead electrocardiogram (ECG). The author also describes cardiac electrophysiology and how this is represented by ECG graphs. Part 2 of this article, to be published next week, will describe 12-lead ECGs and acute coronary syndromes.

An introduction to electrocardiogram interpretation: part 2.

Twelve-lead electrocardiograms (ECGs) record 12 different views of cardiac electrical activity, thus providing more information than bedside monitors, which usually display one or sometimes two leads. Many acutely ill patients have 12-lead ECGs recorded on admission to hospital and at other times, such as pre-operatively or when there are specific cardiac concerns. ECGs have traditionally been an aid to medical diagnosis, but understanding and being able to interpret them enables nurses to summon help urgently if needed. This article describes what each of the 12 leads represents, outlines the main indications for recording 12-lead ECGs and identifies likely causes of error.

Guidance is needed on storing drugs during a heatwave.

DRUGS DURING A HEATWAVE The recent heatwave prompted a number of health warnings. One possible consequence that does not seem to have been considered is the effect of heat on drug stability.

Caring for patients receiving oxygen therapy.

Although respiratory disease can occur at any age, older people are more likely to suffer both acute and chronic respiratory disease. Without sufficient oxygen, cells fail and die, and extensive cell death causes body systems to fail. This article considers the principles of short-term oxygen therapy and offers guidance to nurses who may be required to administer such treatment in their work with older people.

Responsible and accountable.

Healthcare assistants are valuable members of the multi-disciplinary team, using many skills outlined in previous articles in this series. But anyone exceeding the limits of their skills can cause harm and may be called to account. This article explains how everyone is accountable.

Arterial blood gas analysis.

With increasing use of arterial blood gas analysis in various ward and other hospital settings to aid medical diagnosis and management, nurses who can interpret results are often able to initiate earlier interventions and understand the reasons for medical interventions. This article enables nurses to interpret such results.

The evidence.

The issue of nailbrushes seems to be unidentified by infection control literature, including the Infection Control Nurses' Association hand hygiene guidelines. The infection risk is, however, that they will be used as communal items, like a bar of soap, so may transmit micro-organisms. Therefore, in acute care their use should be discouraged. If used, they should be single use, and then disposed of.

Using non-invasive ventilation in acute wards: Part 2.

The second part of this article on non-invasive ventilation (NIV) examines the use of bilevel non-invasive ventilation, discussing the differences between CPAP and bilevel NIV. It also focuses on how to assess and monitor patients receiving either CPAP or bilevel NIV, and patient outcomes.

Using non-invasive ventilation in acute wards: Part 1.

Non-invasive ventilation (NIV) is increasingly being used in domestic and acute health settings. Part one of this article identifies the benefits of NIV and describes the use of continuous positive airway pressure (CPAP). Part two, published in next week's Nursing Standard, discusses bilevel NIV, which has fewer complications and so is largely replacing CPAP. Part two also examines how to monitor and assess patients receiving NIV.