A case study of right ventricular rupture in an elderly victim of motor vehicle crash: incorporating end-of-life care into trauma nursing.

Cardiac trauma fatalities occur in 22% of victims of motor vehicle crash. Blunt cardiac trauma may result in myocardial rupture. Mechanisms of injury include compression, deceleration, laceration, and "hydraulic ram" effect. Diagnosis is difficult because of coexisting injuries and the lack of evidence-based protocols. Physiological changes in the elderly and the presence of comorbid illness result in poor survival rates when myocardial rupture occurs. Trauma nurses must be prepared to provide end-of-life care related to the poor outcome associated with myocardial rupture. This case study reports a right ventricular rupture in an elderly patient involved in a frontal motor vehicle crash.

Pericardial conditions: signs, symptoms and electrocardiogram changes.

This article describes the anatomy and physiology of the pericardium and the signs and symptoms of acute pericarditis, pericardial effusion and cardiac tamponade. It illustrates the likely electrocardiogram findings in each of these conditions and discusses how the results, combined with patient history and physical examination, can help emergency nurses make accurate diagnoses.

Cardiac tamponade resulting from pneumopericardium: case report and implications for the critical care nurse.

Pneumopericardium resulting in cardiac tamponade may be caused by a variety of phenomena. The onset of cardiac tamponade can indicate the presence of a rare underlying condition. As a rare complication of mechanical ventilation and PEEP, our patient experienced pneumopericardium that resulted in cardiac tamponade. Perhaps the most crucial therapy of all is astute critical care nursing assessment of patients at risk of developing the life-threatening complication of cardiac tamponade. All critical care nurses should know the signs and symptoms of cardiac tamponade. Through accurate data collection, frequent monitoring, and immediate referral to the critical care team for medical diagnosis and treatment, a patient's death can be prevented.

Oncologic emergencies in the patient with lymphoma.

OBJECTIVES: To provide a brief overview of the oncologic emergencies most commonly occurring in lymphoma patients. DATA SOURCES: Published articles, research studies, and reference books. CONCLUSIONS: As a result of their malignancy and the treatments they receive, lymphoma patients are at an increased risk for the development of the following oncologic emergencies: superior vena cava syndrome, cardiac tamponade, sepsis, acute tumor lysis syndrome, and increased intracranial pressure. If not recognized and treated quickly, these complications can be deadly. With appropriate medical and nursing management, these emergencies either can be prevented or their complications minimized. IMPLICATIONS FOR NURSING PRACTICE: An awareness of which patients are at risk for these complications and the pathophysiology of each emergency will assist nurses in the implementation of treatment measures.

Cardiac tamponade.

OBJECTIVES: To review the oncologic emergency of cardiac tamponade through a case study presentation/analysis and a discussion of the pathophysiology, diagnosis, treatment, and nursing management. DATA SOURCES: Research studies, review articles, book chapters, abstracts, and clinical practice. CONCLUSIONS: Cardiac tamponade is a potentially life-threatening condition that is not uncommon in the oncology setting. It can result directly from the malignant or metastatic process or from the treatment of the malignancy. Observation and prompt intervention are mandatory to deal effectively with cardiac tamponade. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses play important roles in identifying patients at risk for cardiac tamponade and in recognizing signs and symptoms of cardiac tamponade early so this life-threatening emergency can be treated promptly.

Neoplastic cardiac tamponade.

Once thought to be rare, neoplastic cardiac tamponade is beginning to be recognized more frequently, and is occasionally the presenting symptom of neoplastic disease. This article provides the critical care nurse with the knowledge necessary for care of the patient with neoplastic cardiac tamponade.

Thoracic trauma. Nursing assessment and management.

The importance of the respiratory system to total body functioning cannot be overemphasized. It is imperative that the nurse realize that the first priority in trauma care is to maintain and support the respiratory system. The nurse must be able to rapidly and effectively perform a primary survey, recognize the clinical manifestations of life-threatening thoracic injuries, and intervene in the care of the patient to help stabilize and maintain the patient's respiratory function. The nurse must not only be able to asses, but must also be able to technically intervene rapidly and effectively. Other potential life-threatening injuries must remain uppermost in the nurse's mind. Continual, ongoing monitoring of the patient's status must be an integral part of the nurse's actions. If these activities are judiciously employed, perhaps the mortality rate will decrease and the thoracic trauma victim will survive, capable of leading a full and productive life in our society. This is quality patient care.

Cardiovascular trauma.

Cardiac trauma affects people of all ages from all walks of life. The exact incidence of cardiac trauma is unknown because many individuals die before ever reaching a medical facility for treatment. Reduction in the time from cardiac injury to definitive treatment with continued improvement in rapid emergency transport systems will result in a lower mortality rate. The challenge for nursing is to reduce mortality of victims of cardiac trauma further with prompt nursing diagnosis and effective nursing interventions.