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IV ketamine infusions for the treatment of depression: An evidence based practice analysis
(2018-05-18)
According to the World Health Organization, major depressive disorder (MDD) is a mental health condition which affects a significant portion of the worldwide population and is projected to become the leading cause of ...
The use of thromboelastograpy guided transfusion therapy in trauma: An integrative review
(2018-05-11)
Trauma induced mortality can often be attributed to hemorrhage in the early phase of trauma. Up to one-half of trauma deaths are due to uncontrolled bleeding within the first few hours of injury. Patient survival following ...
The Mallampati test versus the upper lip bite test in predicting difficult intubation
(2018-05-11)
The accurate assessment of the airway is one of the most important skills an anesthesia practitioner should perfect. A difficult intubation is often defined as a Cormack Lehane (CL) grade of III or IV in adult patients. ...
Aseptic administration of intravenous medications by anesthesia providers; A quality improvement project
(2018-05-22)
This quality improvement project addresses the lack of compliance by anesthesia providers in following aseptic techniques for preparing and administering IV medications. An initial 8-question survey was conducted to assess ...
Stress in the student registered nurse anesthetist’s support person: A descriptive study
(2018-05-15)
An understanding of the stressors affecting support persons of Student Registered Nurse Anesthetists (SRNAs) could assist in the development of an intervention to mitigate that stress. A reduction in stress in support ...
Incorporating dexamethasone with local anesthetics in single-shot nerve blocks: An integrative review
(2018-05-17)
Prolonging the duration of analgesia in single-shot nerve blocks (SNBs) continues to be a problem in regional anesthesia. Both IV and perineural dexamethasone have proven to be effective in prolonging the duration of analgesia in SNBs.
Objective: The purpose of this integrative review was to determine how IV and perineural dexamethasone effect duration of analgesia, pain scores, opioid consumption, and complications in patients undergoing SNB.
Methods: An integrative review that included 12 peer-reviewed randomized-controlled trials (RCTs) and one meta-analysis was performed.
Results: The results of the integrative review found that perineural dexamethasone prolonged the duration of analgesia, reduced pain scores, and reduced opioid consumption to a greater extent than IV dexamethasone. IV dexamethasone prolonged the duration of analgesia to a greater extent than local anesthetic with saline and local anesthetic alone. There were no major complications associated with the use of dexamethasone in SNBs.
Conclusions: Perineural dexamethasone is a more effective adjunct in prolonging the duration of analgesia in SNBs compared to IV dexamethasone. IV dexamethasone is an effective, alternative adjunct that can be used to prolong the duration of analgesia in SNBs....
The implications of local anesthetic volume in adductor canal blockade: An integrative review
(2018-05-17)
Introduction: Maintaining patient safety is of utmost concern for anesthesia providers. The adductor canal block, a peripheral nerve block identified as a motor-sparing sensory block, may decrease fall risk and associated ...
Perioperative low-dose ketamine infusion and its impact on postoperative pain: An evidence based practice analysis
(2018-05-31)
Acute pain after surgery is a common problem with multiple consequences. Patients, anesthesia professionals, and surgeons want adequate pain control with minimal side effects. Opioid analgesics are commonly relied upon in ...
Efficacy of chlorhexidine versus Listerine perioperative mouthwash in preventing ventilator-acquired pneumonia: An integrative review
(2018-05-11)
Objective: To compare the safety and efficacy of chlorhexidine versus Listerine in perioperative and intensive care settings in preventing ventilator-acquired pneumonia (VAP).
Methods: An integrative review using a keyword search was conducted in Cochrane, Cinahl, and Google Scholar databases. Data was collected regarding the efficacy of chlorhexidine and Listerine in preventing ventilator-acquired pneumonia, safety and side effect profiles, and in vivoin vitro secondary outcome measures.
Results: Chlorhexidine demonstrates superiority to Listerine in reducing ventilator-acquired pneumonia. Secondary in vivo tests including plaque and gingivitis reduction, and in vitro tests measuring the effect on bacterial loads, also favors chlorhexidine over Listerine. Chlorhexidine has shown to have significantly more side effects compared to Listerine.
Conclusions: Chlorhexidine is justifiably used in preventing ventilator-acquired pneumonia over Listerine. There is a gap in knowledge due to the lack of randomized-controlled trials utilizing Listerine in VAP bundles. Future research should focus on finding an alternative mouthwash to chlorhexidine that is equally effective at reducing VAP incidence, but lacks chlorhexidine’s undesirable side effect profile....