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Assessment of Respiration01:23

Assessment of Respiration

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The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
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SBAR II: Application of SBAR01:14

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SBAR Report from a Nurse to a Health Care Provider
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Assessment of the Rectum and Anus01:25

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Quality Assurance01:19

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Self-Evaluation Maintenance Model01:29

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The Self-Evaluation Maintenance (SEM) model offers a psychological framework to understand how individuals’ self-esteem is influenced by the achievements of others, particularly those with whom they share close personal bonds. The SEM model operates when personal rather than social identity guides individuals. Central to this model is the notion that individuals have an inherent desire to preserve a favorable self-image, which is continuously shaped by interpersonal comparisons and...
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Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
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Is there a role for REBOA? A system assessment.

Riyad Karmy-Jones1, Allen Friend2, David Collins3

  • 1Divisions of Trauma/Critical Care and Thoracic/Vascular Surgery PeaceHealth Southwest Washington Medical Center, USA; PeaceHealth St. John's Medical Center, USA; Legacy Emanuel Medical Center, USA.

American Journal of Surgery
|April 11, 2021
PubMed
Summary

The study found a small number of trauma patients suitable for resuscitative endovascular balloon occlusion of the aorta (REBOA). This limited patient volume suggests REBOA may not be widely applicable in the studied region.

Keywords:
Aortic occlusionHemorrhagic shockREBOATrauma

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Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Vascular Surgery

Background:

  • Hemorrhagic shock poses a significant challenge in trauma care.
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging intervention for managing life-threatening hemorrhage.
  • Quantifying the need for REBOA is crucial for its effective implementation.

Purpose of the Study:

  • To analyze institutional experience with trauma patients in hemorrhagic shock.
  • To quantify the potential need for resuscitative endovascular balloon occlusion of the aorta (REBOA).
  • To identify patient characteristics and injury patterns relevant to REBOA candidacy.

Main Methods:

  • Retrospective review of trauma activations over a three-year period.
  • Patients presenting with hemorrhagic shock were categorized into REBOA Candidate and Non-candidate groups.
  • Comparison of injuries, physiological parameters, outcomes, and interventions between groups.

Main Results:

  • Only 37 (0.44%) of 7643 trauma activations met inclusion criteria; 16 were potential REBOA candidates.
  • REBOA candidates and non-candidates did not differ in injury severity, physiology, age, or transfusion requirements.
  • Of the 16 candidates, 8 (50%) had injuries potentially benefiting from REBOA, while 7 (44%) had injuries that could be harmed by it.

Conclusions:

  • The number of trauma patients who would potentially benefit from REBOA is small in this cohort.
  • Findings do not support system-wide adoption of REBOA in the studied region based on current criteria.
  • Further research is needed to refine REBOA selection criteria and assess its broader utility.