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Biomedical subjects

M J Kocan

Publications and source records attributed to M J Kocan.

6 recordsLinked to original sources
PubMed1995

Intrahospital transport of neuro ICU patients.

Neuroscience intensive care unit (NICU) patients are frequently transported out of the critical care environment for diagnostic and interventional procedures. Four hundred and seventy-one such transports from seventeen clinical centers were studied to identify the characteristics of intrahospital transport. Data collected included the destination and duration of transport, number and type of personnel involved, changes in monitoring and treatment during transport, adverse patient responses and the impact on patients left in the unit. Differences between transports characterized as elective or emergent in nature were noted. Results validate that intrahospital transport of NICU patients is both time and labor intensive. The study also suggests that the optimal process for safe and efficient transport is yet to be designed.

Central Nervous System Diseases↗
PubMed1990

Pulmonary considerations in the critical care phase.

Spinal cord injuries create alterations in ventilatory mechanics that range from complete ventilator dependence in high cervical injuries to the need for an assisted cough to clear secretions in low thoracic injuries. The initial nursing assessment should include the degree of respiratory muscle impairment, the effectiveness of the patient's inspiratory efforts, and the ability to cough. Once the mechanisms responsible for respiratory difficulty have been determined, nursing interventions can be planned to compensate for impaired function. This may involve assisted coughing, frequent chest physiotherapy and suctioning, monitoring vital capacity and ABGs, and use of kinetic beds. Perhaps the greatest challenge for both the nurse and the patient is weaning from mechanical ventilation. Weaning requires a coordinated plan, based on trust between patient and nurse, in order to achieve maximum independence from ventilatory support.

Critical Care↗
PubMed1988

Electrocardiographic changes following subarachnoid hemorrhage.

Electrocardiographic abnormalities are frequently seen in patients who have experienced a subarachnoid hemorrhage (SAH). These changes often mimic those seen in acute myocardial infarction although often patients have no history or other symptoms of cardiac disease. This paper reviews the types of rhythm disturbances seen following SAH and discusses the pathophysiologic basis for these changes. It also presents possible nursing interventions for these patients and explores areas needing further research.

Arrhythmias, Cardiac↗
PubMed1986

A comparison of continuous and intermittent enteral nutrition in NICU patients.

Tube feedings are frequently used for the nutritional support of neurologically impaired patients. Feedings may be delivered either continuously or intermittently. There is little evidence for advantages of one method over the other in patients with neurologic problems. In this study, a convenience sample of 34 adult neurological intensive care unit (NICU) patients were randomly assigned to either continuous or intermittent administration. No significant differences were found in number or consistency of stools per day, presence of blue dye in pulmonary secretions as evidence of aspiration, or in caloric intake as a percent of the patient's nutritional goal. Also, there was no correlation between patient's level of consciousness, based on Glasgow Coma Scale (GCS), and the incidence of aspiration. Implications for nursing practice are discussed.

Adult↗
PubMed1981

Flow-regulated continuous spinal drainage: technical note with case report.

A new method for continuous external drainage of cerebrospinal fluid (CSF) for the treatment of CSF fistulas is described. In this system, CSF is withdrawn continuously from the lumbar subarachnoid space at a controlled flow rate calculated to be slightly less than the natural absorption rate of CSF. Controlled spinal drainage can be achieved using equipment readily available in most intensive care units. This system was developed to prevent pneumocephalus during CSF drainage, as illustrated in the case presentation.

Adult↗