Kerri O Kennedy, Deirdre F Puccetti, Jonathan M Marron, Stephen D Brown
{"title":"Potentially Inappropriate Treatment: Competing Ethical Considerations.","authors":"Kerri O Kennedy, Deirdre F Puccetti, Jonathan M Marron, Stephen D Brown","doi":"10.4037/aacnacc2023884","DOIUrl":"https://doi.org/10.4037/aacnacc2023884","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"161-167"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10365317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pulmonary point-of-care ultrasonography (POCUS) is a quick and essential tool in the diagnosis of various pulmonary pathologies. Pulmonary POCUS can aid in the detection of pneumothorax, pleural effusion, pulmonary edema, and pneumonia, with sensitivity and specificity comparable, if not superior, to those of chest radiograph and chest computed tomography. Knowledge of anatomy and scanning of both lungs in multiple positions is essential for effective pulmonary POCUS. In addition to identifying pertinent anatomic structures such as the diaphragm, liver, spleen, and pleura and identifying specific ultrasonography findings such as A-lines, B-lines, lung sliding, and dynamic air bronchograms, POCUS helps detect pleural and parenchymal abnormalities. Proficiency in pulmonary POCUS is an attainable and essential skill in the care and management of the critically ill patient.
{"title":"Pulmonary Point-of-Care Ultrasonography in the Intensive Care Unit.","authors":"Shameek Gayen, Jin Sun Kim, Parag Desai","doi":"10.4037/aacnacc2023550","DOIUrl":"https://doi.org/10.4037/aacnacc2023550","url":null,"abstract":"<p><p>Pulmonary point-of-care ultrasonography (POCUS) is a quick and essential tool in the diagnosis of various pulmonary pathologies. Pulmonary POCUS can aid in the detection of pneumothorax, pleural effusion, pulmonary edema, and pneumonia, with sensitivity and specificity comparable, if not superior, to those of chest radiograph and chest computed tomography. Knowledge of anatomy and scanning of both lungs in multiple positions is essential for effective pulmonary POCUS. In addition to identifying pertinent anatomic structures such as the diaphragm, liver, spleen, and pleura and identifying specific ultrasonography findings such as A-lines, B-lines, lung sliding, and dynamic air bronchograms, POCUS helps detect pleural and parenchymal abnormalities. Proficiency in pulmonary POCUS is an attainable and essential skill in the care and management of the critically ill patient.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"113-118"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Why Meaningful Recognition and Gratitude Are Important in Addressing Staffing Shortages.","authors":"Nancy Blake","doi":"10.4037/aacnacc2023812","DOIUrl":"10.4037/aacnacc2023812","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"145-147"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jesse E Gibson, Teisha Campbell, Kyle Gibson, Kim Kottemann, Morgan A Krause, Leigh Pack
Background: Although a shortage of organ donors is a continuing global problem in health care, obtaining authorization for donation after an individual experiences a traumatic nonsurvivable event can be difficult.
Objective: To improve organ donation practices at a level II trauma center.
Methods: After reviewing trauma mortality cases and performance improvement metrics with their organ procurement organization's hospital liaison, leaders at the trauma center implemented a multidisciplinary performance improvement initiative to engage the facility's donation advisory committee, provide education for staff members, and increase program visibility to create a more donation-friendly culture for the facility.
Results: The initiative led to an improved donation conversion rate and a greater number of organs procured. Continued education increased staff and provider awareness of organ donation, contributing to the positive outcomes.
Conclusion: A multidisciplinary initiative that includes continuing staff education can improve organ donation practices and program visibility, ultimately benefiting patients in need of organ transplantation.
{"title":"Collaborative Approach to Organ Donation in a Level II Trauma Center.","authors":"Jesse E Gibson, Teisha Campbell, Kyle Gibson, Kim Kottemann, Morgan A Krause, Leigh Pack","doi":"10.4037/aacnacc2023552","DOIUrl":"https://doi.org/10.4037/aacnacc2023552","url":null,"abstract":"<p><strong>Background: </strong>Although a shortage of organ donors is a continuing global problem in health care, obtaining authorization for donation after an individual experiences a traumatic nonsurvivable event can be difficult.</p><p><strong>Objective: </strong>To improve organ donation practices at a level II trauma center.</p><p><strong>Methods: </strong>After reviewing trauma mortality cases and performance improvement metrics with their organ procurement organization's hospital liaison, leaders at the trauma center implemented a multidisciplinary performance improvement initiative to engage the facility's donation advisory committee, provide education for staff members, and increase program visibility to create a more donation-friendly culture for the facility.</p><p><strong>Results: </strong>The initiative led to an improved donation conversion rate and a greater number of organs procured. Continued education increased staff and provider awareness of organ donation, contributing to the positive outcomes.</p><p><strong>Conclusion: </strong>A multidisciplinary initiative that includes continuing staff education can improve organ donation practices and program visibility, ultimately benefiting patients in need of organ transplantation.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"88-94"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical ultrasonography was first used as a diagnostic tool in 1942 by Theodore Karl Dussik to visualize brain structures. Use of ultrasonography broadened to the field of obstetrics in the 1950s and has since expanded to many other medical special-ties owing to ease of use, reproducibility, low cost, and lack of radiation. Advancements in ultrasonography technology have allowed clinicians to perform procedures with greater accuracy and to characterize tissue better than ever before. Piezoelectric crystals used to produce ultrasound waves have been replaced by silicon chips; artificial intelligence can be used to mitigate user variability; and more portable ultrasound probes are available for use with mobile devices. Ultrasonography requires training to be used appropriately, and patient and family education are crucial when performing an examination. Although some data are available regarding the amount of training needed for users to reach proficiency, this topic remains controversial and no standard currently exists.
{"title":"Introduction to Point-of-Care Ultrasonography.","authors":"Dorothy Liu, Erica Roth, Abhijit Pathak","doi":"10.4037/aacnacc2023867","DOIUrl":"https://doi.org/10.4037/aacnacc2023867","url":null,"abstract":"<p><p>Medical ultrasonography was first used as a diagnostic tool in 1942 by Theodore Karl Dussik to visualize brain structures. Use of ultrasonography broadened to the field of obstetrics in the 1950s and has since expanded to many other medical special-ties owing to ease of use, reproducibility, low cost, and lack of radiation. Advancements in ultrasonography technology have allowed clinicians to perform procedures with greater accuracy and to characterize tissue better than ever before. Piezoelectric crystals used to produce ultrasound waves have been replaced by silicon chips; artificial intelligence can be used to mitigate user variability; and more portable ultrasound probes are available for use with mobile devices. Ultrasonography requires training to be used appropriately, and patient and family education are crucial when performing an examination. Although some data are available regarding the amount of training needed for users to reach proficiency, this topic remains controversial and no standard currently exists.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 2","pages":"106-112"},"PeriodicalIF":2.2,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Role of Mentorship in the Transition From Registered Nurse to Acute Care Nurse Practitioner in the Cardiothoracic Intensive Care Unit.","authors":"Lidia Hernandez, Mary Sullivan, Jesus Casida","doi":"10.4037/aacnacc2023426","DOIUrl":"https://doi.org/10.4037/aacnacc2023426","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"34 1","pages":"53-58"},"PeriodicalIF":2.2,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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