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Approximately 172 570 new cases of lung cancer are diagnosed every year. (1) Most patients are treated with thoracotomy or a combination of surgery, radiation therapy, and chemotherapy. Patients with [...]

Our surgical intensive care unit (ICU) is part of an urban, academic territory medical center. Referrals are sent from all over the Southeast in order to access the high level [...]

Neuromuscular blockade is a pharmacological adjunct for anesthesia and for surgical interventions. Neuromuscular blockers can facilitate ease of instrumentation and reduce complications associated with intubation. An undesirable sequela of these agents is residual neuromuscular blockade. Residual neuromuscular blockade is linked to aspiration, diminished response to hypoxia, and obstruction of the upper airway that may occur soon after extubation. If an operation is particularly complex or requires a long anesthesia time, residual neuromuscular blockade can contribute to longer stays in the intensive care unit and more hours of mechanical ventilation. Given the risks of this medication class, it is essential to have an understanding of the mechanism of action of, assessment of, and factors affecting blockade and to be able to identify factors that affect pharmacokinetics. INSET: CASE STUDY. [ABSTRACT FROM AUTHOR]

Postoperative nausea and vomiting is a dreaded, uncomfortable, and unpleasant patient experience that is also a factor contributing to adverse outcomes in postoperative recovery. The key to management of this concern is to identify high-risk patients and to develop a systematic method of assessment, intervention, and evaluation within the perianesthesia care continuum. This discussion outlines the wide range of pharmacological and alternative therapies that are available in clinical practice with a case study to illustrate incorporation of these interventions in critically ill patients. [ABSTRACT FROM AUTHOR]

The article focuses on the Healthy Work Environment (HWE) standards of the American Association of Critical-Care Nurses (AACN). According to the author, it is imperative these standards be integrated in the curriculum of basic nursing education so that nurses are aware of them before they enter the workforce. Two examples of the approaches in this regard are offered, including that of the Capstone College of Nursing in Tuscaloosa, Alabama and the Samford University in Birmingham, Alabama.

A reprint of the article "An Exemplar of Team Competence," by Angela Collins et al., which appeared in Volume 27, Number 2 issue of the "Critical Care Nurse" periodical is presented. It describes a model of critical care nursing team competence at Birmingham Hospital in Alabama, focusing on a situation in which a mother-child pair drove the critical care unit to more complex interactions with almost every service available in the organization. It is said that team members are trained in disciplines that are relatively constant, such as surgery.