Description This Case Study Focuses on the Care of a 58-Year-Old Patient

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Description This case study focuses on the care of a 58-year-old patient who sustains a spinal cord injury as the result of an all-terrain vehicle (ATV) collision and subsequently develops neurogenic and spinal shock. Patient assessments, laboratory and diagnostic tests, and nursing interventions during patient care, with a focus on patient management in the critical care setting, are described. Note: This course is delivered with audio narration. Continuing Education Credit This course qualifies for 1.0 contact hours, which can be earned on this course until December 4, 2020. Objectives/Outcomes After completing this case study, the learner will be able to: describe pertinent assessment, laboratory, and diagnostic data to determine priorities for nursing care interventions for the spinal cord–injured patient at risk for neurogenic shock. differentiate neurogenic shock from the mechanisms of hemodynamic instability associated with other major types of shock (hypovolemic, obstructive, and cardiogenic). describe the nursing care management needs of the spinal cord patient with neurogenic shock when complications develop (such as respiratory failure, abdominal compartment syndrome, and end-organ failure), including end-of-life care. Disclosure The authors and planners have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article. Contributors Marisa B Buchmann, MSN, RN, CPN Subject Matter Expert Karen Wilkinson, MN, PNP Subject Matter Expert Kate Stout, MSN, RN Clinical Editor Lippincott Professional Development Collection Sherry Ratajczak, MSN, PNP Senior Clinical Editor Tahitia Timmons, MSN, RN-BC, OCN Clinical Editor.

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Suplento1 Volumen 71 En
S1 Volumen 71 Mayo 2015 Revista Española de Vol. 71 Supl. 1 • Mayo 2015 Vol. Clínica e Investigación Órgano de expresión de la Sociedad Española de SEINAP Investigación en Nutrición y Alimentación en Pediatría Sumario XXX CONGRESO DE LA SOCIEDAD espaÑOLA DE CUIDADOS INTENSIVOS PEDIÁTRICOS Toledo, 7-9 de mayo de 2015 MESA REDONDA: ¿HACIA DÓNDE VAMOS EN LA MESA REDONDA: EL PACIENTE AGUDO MONITORIZACIÓN? CRONIFICADO EN UCIP 1 Monitorización mediante pulsioximetría: ¿sólo saturación 47 Nutrición en el paciente crítico de larga estancia en UCIP. de oxígeno? P. García Soler Z. Martínez de Compañón Martínez de Marigorta 3 Avances en la monitorización de la sedoanalgesia. S. Mencía 53 Traqueostomía, ¿cuándo realizarla? M.A. García Teresa Bartolomé y Grupo de Sedoanalgesia de la SECIP 60 Los cuidados de enfermería, ¿un reto? J.M. García Piñero 8 Avances en neuromonitorización. B. Cabeza Martín CHARLA-COLOQUIO SESIÓN DE PUESTA AL DÍA: ¿ES BENEFICIOSA LA 64 La formación en la preparación de las UCIPs FLUIDOTERAPIA PARA MI PACIENTE? españolas frente al riesgo de epidemias infecciosas. 13 Sobrecarga de líquidos y morbimortalidad asociada. J.C. de Carlos Vicente M.T. Alonso 68 Lecciones aprendidas durante la crisis del Ébola: 20 Estrategias de fluidoterapia racional en Cuidados experiencia del intensivista de adultos. J.C. Figueira Intensivos Pediátricos. P. de la Oliva Senovilla Iglesias 72 El niño con enfermedad por virus Ébola: un nuevo reto MESA REDONDA: INDICADORES DE CALIDAD para el intensivista pediátrico. E. Álvarez Rojas DE LA SECIP 23 Evolución de la cultura de seguridad en UCIP. MESA REDONDA: UCIP ABIERTAS 24 HORAS, La comunicación efectiva.
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Pediatric Shock
REVIEW Pediatric shock Usha Sethuraman† & Pediatric shock accounts for significant mortality and morbidity worldwide, but remains Nirmala Bhaya incompletely understood in many ways, even today. Despite varied etiologies, the end result †Author for correspondence of pediatric shock is a state of energy failure and inadequate supply to meet the metabolic Children’s Hospital of Michigan, Division of demands of the body. Although the mortality rate of septic shock is decreasing, the severity Emergency Medicine, is on the rise. Changing epidemiology due to effective eradication programs has brought in Carman and Ann Adams new microorganisms. In the past, adult criteria had been used for the diagnosis and Department of Pediatrics, 3901 Beaubien Boulevard, management of septic shock in pediatrics. These have been modified in recent times to suit Detroit, MI 48201, USA the pediatric and neonatal population. In this article we review the pathophysiology, Tel.: +1 313 745 5260 epidemiology and recent guidelines in the management of pediatric shock. Fax: +1 313 993 7166 [email protected] Shock is an acute syndrome in which the circu- to generate ATP. It is postulated that in the face of latory system is unable to provide adequate oxy- prolonged systemic inflammatory insult, overpro- gen and nutrients to meet the metabolic duction of cytokines, nitric oxide and other medi- demands of vital organs [1]. Due to the inade- ators, and in the face of hypoxia and tissue quate ATP production to support function, the hypoperfusion, the body responds by turning off cell reverts to anaerobic metabolism, causing the most energy-consuming biophysiological acute energy failure [2].
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Mechanical Ventilation Guide
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Hypothesis Spinal Shock and `Brain Death': Somatic Pathophysiological
Spinal Cord (1999) 37, 313 ± 324 ã 1999 International Medical Society of Paraplegia All rights reserved 1362 ± 4393/99 $12.00 http://www.stockton-press.co.uk/sc Hypothesis Spinal shock and `brain death': Somatic pathophysiological equivalence and implications for the integrative-unity rationale DA Shewmon*,1 1Pediatric Neurology, UCLA Medical School, Los Angeles, California, USA The somatic pathophysiology of high spinal cord injury (SCI) not only is of interest in itself but also sheds light on one of the several rationales proposed for equating `brain death' (BD) with death, namely that the brain confers integrative unity upon the body, which would otherwise constitute a mere conglomeration of cells and tissues. Insofar as the neuropathology of BD includes infarction down to the foramen magnum, the somatic pathophysiology of BD should resemble that of cervico-medullary junction transection plus vagotomy. The endocrinologic aspects can be made comparable either by focusing on BD patients without diabetes insipidus or by supposing the victim of high SCI to have pre-existing therapeutically compensated diabetes insipidus. The respective literatures on intensive care for BD organ donors and high SCI corroborate that the two conditions are somatically virtually identical. If SCI victims are alive at the level of the `organism as a whole', then so must be BD patients (the only signi®cant dierence being consciousness). Comparison with SCI leads to the conclusion that if BD is to be equated with death, a more coherent reason must be adduced than that the body as a biological organism is dead. Keywords: brain death; spinal cord injury; spinal shock; integrative functions; somatic integrative unity; organism as a whole Introduction Spinal shock is a transient functional depression of the society; its legal de®nition is culturally relative, and structurally intact cord below a lesion, following acute most modern societies happen to have chosen to spinal cord injury (SCI).
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Polytrauma Shock • Trauma Related Costs in the U.S
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A Systematic Review of the Evidence Supporting a Role for Vasopressor Support in Acute SCI
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Trauma: Spinal Cord Injury a, a,b Matthew J. Eckert, MD *, Matthew J. Martin, MD KEYWORDS Spine Spine trauma Spinal cord injury Spinal cord syndromes Spinal shock Spine immobilization KEY POINTS Hypotension following trauma should be considered secondary to hemorrhage until proven otherwise, even in patients with early suspicion of spinal injury. Neurogenic shock and spinal shock are separate, important entities that must be understood. Hypoxia and hypotension should be aggressively corrected because they lead to second- ary spinal cord injury, analogous to traumatic brain injury. Critical care support of multiple organ systems is frequently required early after injury. Early spinal decompression may lead to improved neurologic outcomes in select spinal cord injuries, and prompt consultation with spine surgeons is recommended. Computed tomography (CT) is the gold-standard screening study for evaluation of the spine after trauma and has significantly greater sensitivity and specificity compared with plain radiographs. High-quality CT imaging without evidence of cervical spine injury may be adequate for removal of the cervical immobilization collar in obtunded patients. INTRODUCTION Traumatic spine and spinal cord injury (SCI) occurred in roughly 17,000 US citizens in 2016, with an estimated prevalence of approximately 280,000 injured persons.1 Although the injury has historically been a disease of younger adult men, a progressive increase in SCI incidence among the elderly has been reported over the last few de- cades.2 Upwards of 70% of SCI patients suffer multiple injuries concomitant with spi- nal cord trauma, contributing to the high rates of associated complications during the acute and long-term phases of care.3 SCI is associated with significant reductions in life expectancy across the spectrum of injury and age at time of insult.1 Patients who survive the initial injury face significant risks of medical complications throughout the rest of their lives.
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Spinal Trauma Guideline
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Sepsis and Spinal Trauma
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