B Summers | PubMed Health

PubMed1992

The role of the advanced practice oncology nurse in pain relief.

Oncology nurses have consistently identified relief of pain as a major priority for their specialty. Although many articles provide nurses with advice on ways to improve pain management for people with cancer, few address the practicality and likelihood of these strategies being implemented by an individual nurse. Oncology nurses in advanced practice roles are often in ideal situations to effect some of the positive, broad changes that are needed to improve pain relief. This paper describes the unique contribution that nurses in advanced practice roles can make to pain management and offers a prescription for leadership in practice that can enhance effective pain management for people with cancer.

Education, Nursing, Graduate↗

PubMed1979

Pneumoperitoneum associated with artificial ventilation.

Four adults injured in serious road-traffic accidents developed pneumoperitoneum after artificial ventilation. No case could be attributed to injury or to perforation of a hollow viscus in the belly, but doubt about this in one patient resulted in exploratory laparotomy. In three patients the origin of intraperitoneal air was considered to be leakage through minute ruptures in alveoli subjected to the stress of artificial ventilation, with air tracking to the mediastinum, pleural space, subcutaneous tissues of the neck and chest, and peritoneal cavity. The fourth patient later developed herniation of the stomach through a rupture in the diaphragm, the presence of a pneumothorax on the same side suggesting direct passage of air through the diaphragm. Pneumoperitoneum induced by artificial ventilation is probably more common than reports suggest and should be distinguished clinically and radiologically from that caused by rupture or perforation of a hollow viscus. This will reduce the number of needles laparotomies performed on patients who are already seriously ill.

Adult↗