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Forthcoming Issues
Pediatric Intensive Care Nursing (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - April 30, 2023 Category: Nursing Source Type: research

Evidence-Based Pearls
Trauma remains a leading cause of death among adults. Care of the trauma patient requires highly skilled trauma teams. Trauma care begins in the field, then presents to the emergency room, proceeds to intensive care in many cases, and finally reaches recovery and rehabilitation. For patients, it can be a long road. To be effective, multidisciplinary trauma teams must expertly drill and practice skills, communicate among team members in closed loops, make split decisions affecting patient outcomes, and see the care through to the end. Many disruptions during the course of providing trauma care can alter safe outcomes for pa...
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Jeanette Vaughan Source Type: research

Acute Management of Cervical Spinal Cord Injuries
This article focuses on the pathophysiology, initial presentation, and treatment of cervical spinal cord injury by body system. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Alexandra Hunt, Karen A. McQuillan Source Type: research

Evidence-Based Pearls
The challenge in caring for patients who sustain traumatic chest injuries centers on their complex needs from high acuity and the potential for multisystem effects and complications. Hemorrhage and respiratory compromise are common sequela of thoracic trauma. Patients must be resuscitated and their injuries managed with the primary goals of restoring cardiopulmonary structural integrity and preventing complications. There are evolving strategies for the management of the thoracic trauma victim including damage control resuscitation and surgery, endovascular repairs, and assessments implementing severity scores to aid in pl...
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Eleanor R. Fitzpatrick Source Type: research

Geriatric Trauma and Frailty
Geriatric trauma is increasing in the United States. The care of patients with geriatric trauma is complex due to age-related changes and comorbidities. Patients with geriatric trauma have increased risk of poor outcomes compared with younger patients with trauma, and the highest risk groups are those who have frailty. These patients require special care considerations. Multidisciplinary care can improve outcomes in frail patients with geriatric trauma. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Whitney Villegas Source Type: research

Evidence-Based Pearls
Falls in the ICU are multifaceted, affecting patients of all ages. Historically, falls have been associated with patients in the hospital environment, but fall rates after discharge and readmission rates following a fall are now areas of concern. Recent innovations to prevent risks related to sedation and immobility in the hospital have revealed their impact on ICU patients and fall risk. Risk factors for falls in the ICU relate to length of stay and acuity-related care requirements, such as mechanical ventilation, sedation, and prolonged immobilization. Evidence-based fall prevention includes screening tools, prevention b...
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Alison H. Davis, Aimme J. McCauley Source Type: research

Evidence-Based Pearls
Traumatic brain injury (TBI) is a leading cause of death and disability in the United States, predominantly impacting men. The highest risk for the development of a TBI includes athletes, construction workers, military personnel, and law enforcement. TBI is classified as mild, moderate, or severe. The degree of TBI will determine the severity of clinical manifestations. Management of TBI may be a combination of operative and non-operative interventions. Nursing considerations and management include frequent assessment of vital signs and neurologic status, maintaining hemodynamic stability, early identification of worsening...
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Mary Ritter Source Type: research

The Complexity of Trauma for LGBTQ+ People
Trauma care is complex. Acute and critical care clinicians perceive trauma as a skilled response to critical injury or accident that occurs to patients, but trauma exists on many levels. One of those is a grim reality for patients who are lesbian, gay, bisexual, transgender, queer or questioning, and from other sexual and gender minorities (LGBTQ+). A lifetime of trauma through stigma, discrimination, and victimization is too often present. Owing to distrust of the health care system and clinicians, LGBTQ+  experience health and health care disparities. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Damon B. Cottrell, Lori Aaron-Brija, Emily Berkowitz, Jeffrey Williams Source Type: research

Management of Intra-abdominal Traumatic Injury
Traumatic injuries occur from unintentional and intentional violent events, claiming an estimated 4.4 million lives annually (World Health Organization). Abdominal trauma is a common condition seen in many trauma centers accounting for roughly 15% of all trauma-related hospitalizations (Boutros and colleagues 35) and is associated with significant morbidity and mortality. Following the concepts of Damage Control Resuscitation can reduce mortality drastically. Ultrasound, computed tomography scans, and routine physical examinations are used to make prompt diagnoses, trend injuries, and recognize deterioration of clinical st...
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Shannon S. Gaasch, Christopher L. Kolokythas Source Type: research

Impact of the Social Determinants of Health on Adult Trauma Outcomes
Social determinants of health (SDOHs) have been well studied within the literature in the United States but the effects of these determinants of health on patients with trauma have garnered less attention. The interaction between patients with SDOHs and patients with trauma requires clinicians caring for this population to view patients with trauma through a multifaceted lens. The purpose of this article will be to illuminate the drivers of trauma in the adult population and how the SDOHs and the health-care system come together to contribute to disparities in trauma outcomes. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Quinn Lacey Source Type: research

Using Principles of Therapeutic Communication to Enhance Trauma-Informed Care in the Critical Care Setting to Promote Positive Encounters
Traumatic events such as hospitalization of family members in the intensive care setting can influence communication interactions between health-care workers and family members not just because of the acute situation but because it brings feelings resulting from past traumatic events to the surface. Providing trauma-informed care to all patients and families in the critical care setting improves communication and results in encounters that are less likely to result in an escalation of negative emotions and outbursts and provides an environment that is conducive to interprofessional communication between families, patients,...
Source: Critical Care Nursing Clinics of North America - March 27, 2023 Category: Nursing Authors: Liv Dinoso, Colette Baudoin Source Type: research

Airway Management in Trauma Patients
Airway assessment and management is the first priority in trauma care. The airway can be compromised by traumatic injuries or altered mentation. Airway assessment is conducted during the primary survey. Airway triage in trauma is determined by patient and environmental factors. Initial interventions include positioning maneuvers and suction to clear the airway with supplemental oxygen. Endotracheal intubation and surgical (or “front of neck”) airways are considered definitive. Traumatic airway injuries are rare but have high mortality and morbidity if undetected. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - March 23, 2023 Category: Nursing Authors: Whitney Villegas, Tracey Lawson Source Type: research

Why Trauma Involves Many Issues
Presentations of trauma experienced by patients today are far more complex than seen in previous decades. Patients are impacted by catastrophic pandemics, a brutal economy, and health care teams experiencing critical states of vacancy and battle fatigue. All of these factors affect safety and patient outcomes. Providing expert trauma care from both a physical and mental health standpoint is essential to manage complex cases. A diverse, expert, multidisciplinary team is a fundamental component not only to trauma resuscitation, but towards recovery. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - March 15, 2023 Category: Nursing Authors: Jeanette Vaughan, Whitney Villegas Tags: Preface Source Type: research

Trauma in the Obstetric Patient
The authors provide a concise, comprehensive overview of the unique anatomic and physiologic features of pregnancy as well as modification and considerations important for the management of the pregnant trauma patient. (Source: Critical Care Nursing Clinics of North America)
Source: Critical Care Nursing Clinics of North America - March 15, 2023 Category: Nursing Authors: Halli Carr, Renee ’ Jones Source Type: research

Ethical Challenges in the Care of the Trauma Patient
A patient with trauma presents a unique and/or complex challenge to the ethical foundation that guides nursing care. Patients with trauma, by the very nature of the suddenness of their injury, are unable to predetermine or express their wishes in the event of a catastrophic injury. The providers who care for patients with trauma do not have an established patient relationship to aid them in decision-making based on what they think the patient would wish or based on past conversations. Yet, they provide expert care and use ethical principles to direct their professional responsibility to these patients. (Source: Critical Ca...
Source: Critical Care Nursing Clinics of North America - March 10, 2023 Category: Nursing Authors: Maureen Frances McLaughlin Source Type: research