Continuous-flow left ventricular assist devices: Changing the physiological paradigm for critical care nurses

摘要

Critical care nurses rely on their understanding of human physiology as they navigate the use of infusion pumps, ventilators, drains, and monitoring devices that help them to support and detect changes in their critically ill patients.. They know that a QRS complex on the ECG monitor should cause an associated upstroke on the arterial catheter tracing and that failure to do so may constitute pulseless electrical activity and an emergency. Even without an arterial catheter, critical care nurses know that the inability to measure blood pressure-using either a stethoscope to detect the familiar Korotkoff sounds or an automated noninvasive blood pressure device-may represent a critically low blood pressure that, without quick intervention, may cause significant harm to the patient. They rely on their ability to quickly and noninvasively evaluate oxygenation using pulse oximetry to guide oxygen and ventilator therapy and to indicate when changes in pulmonary function are occurring. Critical care nurses have learned to use all of their senses to detect minute changes in patient condition, early warning systems that can help them to avert negative outcomes.