Opinion
Board’s eye view Keeping cool WHAT USED to be referred to as ‘cooling’ is now known as ‘targeted temperature management’. The Resuscitation Council UK states in the sixth edition of its advanced life support manual that cooling out-of-hospital survivors of cardiac arrest to between 32°C and 34°C for between 12 and 24 hours reduces their risk of mortality and produces better neurological outcomes. Such cooling is thought to lower cerebral metabolic rate, which in turn reduces the release of amino acids and free radicals linked to cell damage after cardiac arrest. Recent work demonstrates, however, that stabilising a patient’s temperature at 36°C for 24 hours, and then at 37°C for 48 hours, produces similar results. It is becoming accepted, therefore, that temperature stability rather than cooling is crucial to good patient outcomes. The Resuscitation Council UK and other expert bodies are expected to review all relevant studies, and to issue next autumn resuscitation guidelines that are consistent with their findings. In the meantime, how should emergency nurses manage patients with cardiac arrest? Here at Queen Elizabeth, guidelines for the management of comatose survivors of non-traumatic cardiac arrest are in line with the more recent research. Management can begin at any location in the hospital and when patients are being transferred to cardiac catheter laboratories or intensive care units. It involves the application of cooling pads to a patient’s skin and then the insertion of an intravenous temperature control catheter into a femoral vein. Whatever the Resuscitation Council UK includes in its 2015 guidelines, one thing is certain: hyperthermia in patients who have had cardiac arrest is detrimental to outcome. Hannah Bryant is a resuscitation officer at Queen Elizabeth Hospital, Birmingham, and a member of the Emergency Nurse editorial advisory board
10 December 2014 | Volume 22 | Number 8
Reviews Clinical Research Manual Jennifer Cavalieri and Mark Rupp Sigma Theta Tau International Honor Society of Nursing £27.15 | 336pp ISBN: 9781937554637 THE TERM ‘manual’ in the title of this book interested me but after delving into it I realised that much of the authors’ experience of research was in the United States and their findings may not apply to the UK. For example, all of the regulatory bodies to which they refer are American. From the outset, the authors indicate that research staff are separate from clinical staff.
Managing Minor Musculoskeletal Injuries and Conditions David Bradley Wiley Blackwell Publishing £32.99 | 394pp ISBN: 9780470673102 IT WAS a great pleasure to review this book, which is a comprehensive collection of musculoskeletal minor injuries and conditions that are seen on a daily basis in emergency departments throughout the UK and Ireland. It is broken up into three parts, with part one focusing on the importance of history taking, examination and accurate patient documentation, part two reviewing the upper body and part three the lower body. The anatomically organised chapters in parts two and three cover the neck, shoulder, elbow, wrist, hand, lower back, hip, knee, leg, ankle and foot.
This may be the case in much of the US, but in the UK these roles tend to be mixed and matched to the benefit of both. The book does provide some useful tips for research-minded nurses, however, specifically about data ownership, project registration, adverse events, consent and budgeting. The tools and templates collected in the appendix may help some nurses manage research projects, although the organisations in which they work are likely to have their own documents and internal processes. This book is intended for nurses already involved in research rather than those dipping their toes into the subject, and will be especially useful to those involved in research projects with US partners. Irene Mabbott is a practice development co-ordinator at Sheffield Teaching Hospitals NHS Foundation Trust
In each of these, the author discusses applied anatomy and physiology, history and mechanism of injury, patient examination, and minor musculoskeletal injuries and conditions before a set of multiple choice questions at the end. Each chapter is well supported with superb illustrations of the anatomy of each area covered. The book also contains photographs of various conditions or injuries such as paronychia or mallet finger. It provides online access to PowerPoint presentations of X-rays for interpretation, the 25-photograph clinical tutorial, documentation exercises, as well as history-taking, ethical and legal scenarios. Although targeted at senior nurses and paramedics, this book would be an invaluable resource for junior doctors and nurse practitioners working in minor injury or emergency care settings. Lynda Gibbons is a registered advanced nurse practitioner in the emergency department at Our Lady’s Hospital, Navan, County Meath, Ireland
What’s your view? If you want to express your opinions on any of the issues in Emergency Nurse, email the managing editor at [email protected] EMERGENCY NURSE
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Board’s eye view Keeping cool WHAT USED to be referred to as ‘cooling’ is now known as ‘targeted temperature management’. The Resuscitation Council UK states in the sixth edition of its advanced life support manual that cooling out-of-hospital survivors of cardiac arrest to between 32°C and 34°C for between 12 and 24 hours reduces their risk of mortality and produces better neurological outcomes. Such cooling is thought to lower cerebral metabolic rate, which in turn reduces the release of amino acids and free radicals linked to cell damage after cardiac arrest. Recent work demonstrates, however, that stabilising a patient’s temperature at 36°C for 24 hours, and then at 37°C for 48 hours, produces similar results. It is becoming accepted, therefore, that temperature stability rather than cooling is crucial to good patient outcomes. The Resuscitation Council UK and other expert bodies are expected to review all relevant studies, and to issue next autumn resuscitation guidelines that are consistent with their findings. In the meantime, how should emergency nurses manage patients with cardiac arrest? Here at Queen Elizabeth, guidelines for the management of comatose survivors of non-traumatic cardiac arrest are in line with the more recent research. Management can begin at any location in the hospital and when patients are being transferred to cardiac catheter laboratories or intensive care units. It involves the application of cooling pads to a patient’s skin and then the insertion of an intravenous temperature control catheter into a femoral vein. Whatever the Resuscitation Council UK includes in its 2015 guidelines, one thing is certain: hyperthermia in patients who have had cardiac arrest is detrimental to outcome. Hannah Bryant is a resuscitation officer at Queen Elizabeth Hospital, Birmingham, and a member of the Emergency Nurse editorial advisory board
10 December 2014 | Volume 22 | Number 8
Reviews Clinical Research Manual Jennifer Cavalieri and Mark Rupp Sigma Theta Tau International Honor Society of Nursing £27.15 | 336pp ISBN: 9781937554637 THE TERM ‘manual’ in the title of this book interested me but after delving into it I realised that much of the authors’ experience of research was in the United States and their findings may not apply to the UK. For example, all of the regulatory bodies to which they refer are American. From the outset, the authors indicate that research staff are separate from clinical staff.
Managing Minor Musculoskeletal Injuries and Conditions David Bradley Wiley Blackwell Publishing £32.99 | 394pp ISBN: 9780470673102 IT WAS a great pleasure to review this book, which is a comprehensive collection of musculoskeletal minor injuries and conditions that are seen on a daily basis in emergency departments throughout the UK and Ireland. It is broken up into three parts, with part one focusing on the importance of history taking, examination and accurate patient documentation, part two reviewing the upper body and part three the lower body. The anatomically organised chapters in parts two and three cover the neck, shoulder, elbow, wrist, hand, lower back, hip, knee, leg, ankle and foot.
This may be the case in much of the US, but in the UK these roles tend to be mixed and matched to the benefit of both. The book does provide some useful tips for research-minded nurses, however, specifically about data ownership, project registration, adverse events, consent and budgeting. The tools and templates collected in the appendix may help some nurses manage research projects, although the organisations in which they work are likely to have their own documents and internal processes. This book is intended for nurses already involved in research rather than those dipping their toes into the subject, and will be especially useful to those involved in research projects with US partners. Irene Mabbott is a practice development co-ordinator at Sheffield Teaching Hospitals NHS Foundation Trust
In each of these, the author discusses applied anatomy and physiology, history and mechanism of injury, patient examination, and minor musculoskeletal injuries and conditions before a set of multiple choice questions at the end. Each chapter is well supported with superb illustrations of the anatomy of each area covered. The book also contains photographs of various conditions or injuries such as paronychia or mallet finger. It provides online access to PowerPoint presentations of X-rays for interpretation, the 25-photograph clinical tutorial, documentation exercises, as well as history-taking, ethical and legal scenarios. Although targeted at senior nurses and paramedics, this book would be an invaluable resource for junior doctors and nurse practitioners working in minor injury or emergency care settings. Lynda Gibbons is a registered advanced nurse practitioner in the emergency department at Our Lady’s Hospital, Navan, County Meath, Ireland
What’s your view? If you want to express your opinions on any of the issues in Emergency Nurse, email the managing editor at [email protected] EMERGENCY NURSE
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 24, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
