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Biomedical subjects

K S Bizek

Publications and source records attributed to K S Bizek.

7 recordsLinked to original sources
PubMed1999

Patient responses during rapid terminal weaning from mechanical ventilation: a prospective study.

OBJECTIVE: To describe and analyze patient responses to rapid terminal weaning from mechanical ventilation. DESIGN: A prospective, descriptive, correlational study. SETTING: An urban, university-affiliated, trauma/emergency hospital. PATIENTS: A convenience sample of 31 adult patients experiencing withdrawal of mechanical ventilation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Physiologic (peripheral oxygen saturation, end-tidal CO2, heart rate, and respiratory rate) and comfort (electroencephalogram [EEG], Bizek Agitation Scale, and the COMFORT scale) measures were collected at baseline, during, and after the terminal weaning procedure. Clinical status was measured using the Acute Physiology and Chronic Health Evaluation score, Glasgow Coma Scale, and PaO2/F(IO2). Duration of survival after the wean inversely correlated with illness severity but did not correlate with consciousness, use of analgesia/sedation, or pulmonary function. Respiratory rate and oxygen saturation changed significantly during the wean but not end-tidal CO2. Patients remained comfortable with little or no analgesia/sedation, in a predominantly comatose sample. Subjective measures of comfort strongly correlated with objective data from bispectral analysis of EEG. CONCLUSIONS: Patients with altered consciousness or coma can be kept comfortable during a rapid terminal weaning procedure with morphine and benzodiazepines in low doses. Comfort can be reliably evaluated using subjective scales.

APACHE↗
PubMed1998

Integrating technology with compassionate care: withdrawal of ventilation in a conscious patient with apnea.

This case was atypical because the patient was conscious and apneic. The usual responses that indicate a patient's distress during terminal weaning would not have been evident in this patient. Introducing noninvasive monitoring of end-tidal CO2 and SpO2 and using BIS allowed the weaning to progress with confidence that the patient was as comfortable as possible. We think we kept our commitment to HD to honor his wishes by using the most humane method we could devise, and to address his family's needs at the same time.

Aged↗
PubMed1995

Optimizing sedation in critically ill, mechanically ventilated patients.

Patients on mechanical ventilators may experience discomfort, fear, anxiety, and pain. Sedative and adjunctive medications often are prescribed on an "as needed" basis. This article reviews current trends in sedation administration and suggests strategies for optimizing sedation management. Pharmacologic properties of commonly used medications are presented.

Procedural Sedation↗
PubMed1990

Study of educational experiences, support, and job satisfaction among critical care nurse preceptors.

Experienced critical care staff nurses are frequently called to serve as clinical preceptors for nurses and nursing students who are unfamiliar with the critical care unit. These critical care nurse preceptors require educational preparation, continuing education, and support for their role. This descriptive correlational study surveyed 73 critical care nurse preceptors at 10 teaching hospitals in a metropolitan area in the Midwest. Forty-eight (65.8%) participants reported receiving some type of educational experience to prepare them for the role of preceptor. Only 24.7% of the respondents, however, participated in continuing education experiences related to the preceptor role. Job satisfaction was measured with a 48-item Likert scale developed for nurses by Slavitt et al. No significant differences in job satisfaction were reported for preceptors who received educational preparation and those who did not. However, the type of unit in which the preceptor worked did affect job satisfaction. Critical care preceptors in units classified as intermediate care and emergency departments had greater levels of job satisfaction than nurses working in intensive care units (t[68] = 2.52, p = 0.01). In addition, the longer the preceptor worked in critical care, the lower the level of job satisfaction (r = -0.210, p = 0.04). Job satisfaction was also influenced by the support preceptors received from their institution; a significant positive correlation was seen between this support and the level of job satisfaction. A description of the format and content of preparation programs for critical care preceptors was also provided as a result of this study.

Adult↗