September 17, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In critically ill patients, induction agents have the potential to exaggerate hypotension. Peri-intubation cardiac arrest, typically pulseless electrical activity, complicates up to 4% of emergency rapid sequence intubations.

September 16, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Rapid sequence intubation is the recommended technique for intubation of a patient in status asthmaticus. Difficult airway considerations are complex in an asthmatic patient because of impending respiratory arrest.

September 15, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Because of the propensity of propofol to cause hypotension through vasodilation and direct myocardial depression, the dosage is reduced or the drug is avoided altogether in hemodynamically compromised patients.

September 14, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Because of its superior hemodynamic profile, ketamine is an excellent alternative to etomidate for a hemodynamically unstable patient. However, all sedative induction agents can provoke further hypotension or cardiovascular collapse.

September 13, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The principal uses of ketamine in airway management are as a sedative agent for awake intubation and as the induction agent during rapid sequence intubation for patients with acute severe asthma or hemodynamic instability.

September 12, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
As a dissociative anesthetic agent, ketamine induces a cataleptic state rather than a true unconscious state. The patient has anesthesia but may have her or his eyes open. Protective airway reflexes and ventilatory drive usually are preserved.

September 11, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Ketamine has been widely used as a general anesthetic agent since 1970. After an IV dose of 1 to 2 mg/kg, ketamine produces loss of awareness within 30 seconds, peaks in approximately 1 minute and has a clinical duration of 10 to 15 minutes.

September 10, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
When a patient has a contraindication to succinylcholine, rocuronium bromide is the paralytic agent of choice. Rocuronium achieves intubating conditions similar to those of succinylcholine and lasts 50 minutes.

September 9, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Succinylcholine has been associated with severe hyperkalemia when administered to patients with specific predisposing clinical conditions. The mechanism is related to receptor upregulation on the postsynaptic muscle membrane.

September 8, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Succinylcholine is rapidly active, typically producing intubating conditions within 45 seconds of administration by rapid IV bolus injection. The clinical duration of action before spontaneous respiration is 6 to 10 minutes.

September 7, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Glottic visualization is paramount in airway management. With direct laryngoscopy, if the vocal cords can be seen, the chance of intubation success is high. However, when the glottic aperture cannot be visualized, intubation success is less likely.

September 6, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Airway difficulty exists on a spectrum and is contextual to the provider's experience, environment and armamentarium of devices. Airways predicted to be difficult when using a direct laryngoscope may not be difficult when video laryngoscope is used.

September 5, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Preintubation assessment should evaluate the patient for potential difficult intubation and difficult BMV, placement of and ventilation with an extraglottic device and cricothyrotomy. Knowledge of all four domains is crucial to successful planning.

September 4, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Gas exchange is required for vital organ function. Ventilatory failure that is not reversible by clinical means or persistent hypoxemia despite oxygen supplementation is a primary indication for intubation.

September 3, 2024

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
A patent airway is essential for adequate ventilation and oxygenation. If a patient is unable to maintain a patent airway, the airway should be established by using repositioning, chin lift, jaw thrust, or insertion of an oral or nasal airway.