RESUMEN
OBJECTIVES: To review the specific nursing and infection-control issues that arise during the care of patients receiving high-frequency oscillatory ventilation (HFOV). DATA SOURCE: Published articles, governmental guidelines, and hospital procedures and practices. DATA SUMMARY: Nurses, respiratory therapists, and other clinicians caring for patients receiving HFOV need to be aware of specific differences in patient assessment, including close observation for symmetric chest-wall vibrations. In addition, management of sedation with or without neuromuscular blockade and effective communication with the patients are essential nursing skills needed with the use of HFOV. From an infection-control standpoint, HFOV is considered a high-risk respiratory procedure because of the inability to effectively filter all respiratory secretions. Appropriate infection-control precautions, including patient location and use of personal protective equipment, need to be considered when implementing HFOV in the intensive care unit. CONCLUSIONS: Important infection-control and nursing issues exist that are specific to the use of HFOV. These issues should be addressed with appropriate staff education before the implementation of HFOV in an intensive care unit.
Asunto(s)
Ventilación de Alta Frecuencia/enfermería , Control de Infecciones/métodos , Humanos , Unidades de Cuidados Intensivos , Síndrome de Dificultad Respiratoria/terapiaRESUMEN
High frequency oscillatory ventilation is a new mode of ventilatory support of acute respiratory failure in the pediatric population. Delineating the nursing care required of this fragile group of infants and children is challenging, because there is a paucity of published data and national clinical experience. The author reviews a management plan that was used to guide the care of over 40 patients, ranging in age from 1 months to 24 years, with acute respiratory failure supported on high frequency oscillatory ventilation. In total, seven patient-care problems and associated interventions are delineated.
Asunto(s)
Ventilación de Alta Frecuencia/enfermería , Planificación de Atención al Paciente , Insuficiencia Respiratoria/enfermería , Adolescente , Adulto , Niño , Preescolar , Humanos , Lactante , Recién Nacido , Diagnóstico de EnfermeríaRESUMEN
The introduction of high-frequency oscillatory ventilation (HFOV) to the intensive care nursery has stimulated us to develop infant care protocols for babies so treated. We identified specific areas unique to the SensorMedics HFOV and initiated nursing techniques to address each of the following areas: assessment, airway care, feedings, positioning, and safety. In summary, while on HFOV, an infant's assessment and care need not be minimized.
Asunto(s)
Ventilación de Alta Frecuencia/enfermería , Enfermería Neonatal/métodos , Planificación de Atención al Paciente , Protocolos Clínicos , Ventilación de Alta Frecuencia/efectos adversos , Ventilación de Alta Frecuencia/instrumentación , Ventilación de Alta Frecuencia/métodos , Humanos , Recién NacidoRESUMEN
This reflection on practice is written by two members of a primary nurse team at the Chelsea and Westminster intensive care unit (ICU)/nursing development unit (NDU). Johns's (1993) tool for structured guided reflection was used to reflect on the care of an ICU patient given by her primary and associate nurse. The issues highlighted include: The importance of knowing your patient through a primary nursing approach. Collaboration between the primary nursing team and the anaesthetists. Negotiation between the patient, her family and the primary nursing team. Empowerment of the patient to express her view.
Asunto(s)
Cuidados Críticos/métodos , Ventilación de Alta Frecuencia/enfermería , Enfermería Primaria/métodos , Anciano , Conducta Cooperativa , Femenino , Humanos , Defensa del Paciente , Grupo de Atención al Paciente/organización & administración , Poder Psicológico , Cuidado Terminal/métodosAsunto(s)
Ventilación de Alta Frecuencia/enfermería , Ventilación con Presión Positiva Intermitente/enfermería , Respiración con Presión Positiva/enfermería , Ventilación de Alta Frecuencia/métodos , Humanos , Ventilación con Presión Positiva Intermitente/métodos , Evaluación en Enfermería , Respiración con Presión Positiva/métodosRESUMEN
El artículo describe una modalidad de asistencia respiratoria mecánica utilizada en recién nacidos y niños con afecciones clínicas respiratorias introduciendo el uso del óxido nítrico (ON). Explica los cuidados de enfermería correspondientes y ofrece una breve referencia a las características de ON