During our podcast interview with Jennifer Norgaard RN, a NICU clinical nurse specialist at a level IV NICU in California, we learned about the process of setting up protocols to treat infants with hypoxic-ischemic encephalopathy (HIE). Norgaard explained that some centers see only a few of these babies each year while others see many more. In either case, HIE is not one of the more common diagnoses seen in the NICU.
TTM After Stroke, Intra-Cerebral Hemorrhage, and Subarachnoid Hemorrhage
The panel found very little evidence to support the use of TTM in the hypothermic range in these clinical settings. Their recommendations for this group were all in the expert opinion category.
Because fever is a common complication in these situations and associated with poorer outcomes, the panel recommended using TTM for normothermia in severe ischemic stroke.
New Recommendations for Use of Targeted Temperature Management in Critical Care Settings
For intensivists seeking guidance, a recent report in the Annals of Intensive Care gives detailed recommendations on the use of targeted temperature management (TTM) for critically ill patients. The report, co-authored by several groups of French physicians, examines the evidence of TTM in a variety of clinical situations, provides 30 specific recommendations, and rates the strength of evidence supporting each recommendation. The result is a thorough yet practical set of guidelines for front-line practitioners.
Dear High-Acuity and Critical Care Nurses,
Thank you for saving my life.
I’m not exaggerating--you saved my life, and for that, I’m eternally grateful.
In April 2016, I had a heart attack. I was perfectly alert in the ER, but on the table in the cardiac cath lab, I went into a bad rhythm, then into cardiogenic shock. After that, I went into liver failure and kidney failure. Some heroic efforts were needed to save me, including a few days on an Impella pump. The medical team called in my family to “say goodbye,” but I fooled them and recovered. I spent 10 days in the cardiac care unit, 7 of them under such heavy sedation that I don’t remember anything from that week. Within a few months, I was back to work full time, resumed all my usual activities, and I thank God for each day I’m alive.
Education, Excellence, and Inspiration through the NTI Conference connections.
The American Association of Critical-Care Nurses will be conducting their 2018 National Teaching Institute & Critical Care Exposition at the Boston Convention and Exhibition Center in Boston, Massachusetts from May 20th to the 24th.
Temperature management systems control patient temperatures within a narrow range. The most common application of these systems is to maintain normothermia while patients are in the OR to minimize perioperative adverse outcomes. Other applications include deliberate hypothermia used during cardiopulmonary bypass surgery and localized heating and cooling therapy.
Topics: Preventive Maintenance
In continuing our podcast interview with Jennifer Norgaard, a NICU Clinical Nurse Specialist at a level IV NICU in California, she explained that while hypoxic-ischemic encephalopathy (HIE) may not be preventable, therapeutic hypothermia (TH), or targeted temperature management (TTM), is a promising treatment for neonates. She indicated that It provides a way to reduce brain cell damage, by cooling eligible infants within 6 hours of birth to a body temperature of 34º C +/- 0.5º for 72 hours before slowly rewarming them to normal temperature.(3)
As a nurse in the NICU, you know the devastation parents of newborns feel when they discover their much anticipated newborn baby has suffered oxygen deprivation during the birthing process and is critically ill. A decrease in the oxygen supply to the baby’s brain just prior to or during delivery may cause hypoxic ischemic encephalopathy (HIE) which is a leading cause of death or permanent brain damage in newborns.(1)
As healthcare costs and insurance coverages continue to be volatile, not-for-profit and government, as well as for-profit hospitals, continue to seek ways to lower expenses without compromising patient care. Equipment maintenance and downtime can be targeted by managers and supervisors in every department as areas that can be more cost-effective.
Topics: Preventive Maintenance
Topics: American Heart Association
*This article is intended for educational purposes only and is not intended as medical advice or as a substitute for the medical judgment of a physician in evaluating patients. For more information, please review the information sources referenced in this article. For more information on CSZ, please visit our website or call us at 1-800-989-7373.