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Contents
- Front matter
  - Preface
  - Acknowledgements
  - Abbreviations and symbols
- Chapter 1 The critical care continuum
  - Chapter 1 The critical care continuum
  - Why hospital-wide critical care?
  - Models of critical care outreach
  - Aims of critical care outreach
  - Intervening pre-critical care admission
  - Intervening post-critical care discharge
  - Emergency recognition and response
  - Assessment of the acutely unwell patient
  - Immediate responses
  - Secondary transfer of critically ill patients
- Chapter 2 The critical care environment
  - Chapter 2 The critical care environment
  - Who benefits from critical care?
  - Admission guidelines
  - Discharge guidelines
  - Organization: design of units
  - Organization: safety in critical care
  - Organization: staffing
  - Organization: team working
  - Stress and burnout in critical care
  - Performance: ensuring quality of care
  - Clinical audit
  - Critical care scoring systems
  - Infection and the critical care environment
  - Hand washing and disinfection
- Chapter 3 The patient in the critical care environment
  - Chapter 3 The patient in the critical care environment
  - Stress: the physiological response
  - Stressors in critical care
  - Anxiety and fear
  - Pain
  - Management of pain
  - Delirium
  - Sedation
  - Sedative drugs
  - Communication
  - Patient perceptions of critical care
  - Sensory imbalance and temporal disorientation
  - Diurnal rhythm and sleep disturbance
  - The dying patient: non-escalation or withdrawal of treatment
  - The dying patient: supporting family and loved ones
- Chapter 4 Nursing skills to support critical care patients
  - Chapter 4 Nursing skills to support critical care patients
  - The nursing effect
  - Priorities of care
  - Bedside emergency equipment checks
  - Prevention of immobility complications
  - Preventing complications: hospital acquired infection
  - Oral hygiene
  - Eye care
  - Communication: the patient
  - Communication: the family and loved ones
  - Communication: the team
- Chapter 5 Cardiovascular monitoring
  - Chapter 5 Cardiovascular monitoring
  - Electrocardiogram
  - Arrhythmias: general
  - Arrhythmias: disorders of impulse formation
  - Arryhthmias: disorders of impulse conduction
  - The 12-lead electrocardiogram
  - Blood pressure
  - Central venous pressure
  - Pulmonary artery catheter: use
  - Pulmonary artery catheter: insertion and removal
  - Cardiac output: thermodilution
  - Cardiac output: peripheral dilution techniques
  - Cardiac output: Doppler ultrasound
  - Cardiac output: other techniques
- Chapter 6 Respiratory monitoring
  - Chapter 6 Respiratory monitoring
  - Pulse oximetry
  - Capnography
  - Pulmonary function tests
  - Blood gas analysis
- Chapter 7 Neurological monitoring
  - Chapter 7 Neurological monitoring
  - Neurological assessment
  - Intracranial pressure (ICP) monitoring
  - Jugular venous bulb oximetry
  - Electrocardiogram, Bispectral Index, cerebral function monitor, and transcranial Doppler monitoring
- Chapter 8 Laboratory monitoring
  - Chapter 8 Laboratory monitoring
  - Electrolytes (Na⁺, K⁺, Cl⁻, HCO₃⁻)
  - Urea and creatinine
  - Calcium and magnesium
  - Full blood count
  - Cardiac injury markers
  - Liver function tests
  - Coagulation monitoring
  - Microbiology
  - Virology, serology, and assays
  - Toxicology
- Chapter 9 Miscellaneous monitoring
  - Chapter 9 Miscellaneous monitoring
  - Intra-abdominal pressure measurement
  - Urinalysis
  - Lactate
  - Temperature
  - Safety and reliability
- Chapter 10 Respiratory support: mechanical ventilation
  - Chapter 10 Respiratory support: mechanical ventilation
  - Physiology overview: movement of gases I
  - Physiology overview: movement of gases II
  - Physiology overview: gas exchange I
  - Physiology overview: gas exchange II
  - Physiology overview: carriage of gases and cell processes to produce energy
  - Arterial blood gas analysis
  - Respiration: patient assessment I
  - Respiration: patient assessment II
  - Hypoxaemia and hypoxia
  - Oxygen therapy
  - Non-invasive ventilation
  - Intermittent positive pressure ventilation: indications
  - Intermittent positive pressure ventilation: physiological effects
  - Intermittent positive pressure ventilation: modes of ventilation
  - Ventilator settings
  - Pressure–volume relationships
  - Troubleshooting
  - Improving oxygenation in the ventilated patient
  - Managing hypercapnia in severe pulmonary disease
  - High frequency ventilation
- Chapter 11 Caring for the patient on intermittent positive pressure ventilation
  - Chapter 11 Caring for the patient on intermittent positive pressure ventilation
  - Endotracheal tubes
  - Intubation
  - Maintaining a patent airway
  - Humidification
  - Suctioning
  - Extubation
  - Tracheostomy
  - Care of the patient with tracheostomy tube
  - Decannulation of tracheal tubes
  - Care of a patient on intermittent positive pressure ventilation: positioning
  - General care of the patient on a ventilator
  - Weaning
  - Weaning the long-term ventilated patient
  - Pneumothorax, tension pneumothorax, and bronchopleural fistulae
  - Pneumonia
  - Acute asthma I
  - Acute asthma II
  - Acute respiratory distress syndrome
  - Chronic obstructive pulmonary disease
  - Pulmonary embolus (PE)
- Chapter 12 Cardiac disorders
  - Chapter 12 Cardiac disorders
  - The cardiovascular system
  - Blood pressure and flow
  - Determinants of cardiac performance I
  - Determinants of cardiac performance II
  - Oxygen delivery and consumption
  - Pacing
  - Hypotension
  - Hypertension
  - Assessment of the patient with chest pain
  - Acute coronary syndromes (ACS)
  - Angina pectoris
  - Thrombolytic therapy
  - Acute heart failure/cardiogenic shock
  - Pericarditis and pericardial tamponade
  - Infective endocarditis (IE)
  - Cardiomyopathy and myocarditis
  - Anti-arrhythmic drugs I
  - Anti-arrhythmic drugs II
  - Drugs used in the treatment of low cardiac output and/or hypotension
  - Drugs used in the treatment of hypertension
  - Electrical cardioversion
  - Cardiac arrest and cardiopulmonary resucitation
  - Ongoing management of cardiac arrest
  - Management of post-cardiac arrest
- Chapter 13 Neurological care
  - Chapter 13 Neurological care
  - Neurological observations
  - General principles in the care of neuroscience patients
  - Neurology
  - Cranial nerve dysfunction
  - Sympathetic storming and agitation
  - Respiratory
  - Cardiovascular
  - Sedation, analgesia, and NMBAs
  - Fluids and electrolytes
  - Nutrition
  - Elimination
  - Positioning and mobility
  - Oral and eye care
  - Sleep deprivation
  - Communication
  - Traumatic brain injury (TBI)
  - Aneurysmal subarachnoid haemorrhage (SAH)
  - Guillain-Barre syndrome (GBS)
  - Myasthenia gravis (MG)
  - Infection and inflammation of central nervous system
  - Generalized convulsive status epilepticus
  - Brainstem testing and organ donation
  - Brainstem function tests
- Chapter 14 Renal disorders
  - Chapter 14 Renal disorders
  - Acute renal failure
  - Investigations and diagnosis of acute renal failure
  - Management of acute renal failure (ARF)
  - Renal replacement therapy: basic principles
  - Types of renal replacement therapy
  - Haemofiltration
  - Intermittent haemodialysis
  - Anticoagulation therapy for extracorporeal circuits
  - Specific disorders associated with acute renal failure
- Chapter 15 Gastrointestinal dysfunction and nutrition
  - Chapter 15 Gastrointestinal dysfunction and nutrition
  - Overview of physiology I
  - Overview of physiology II
  - Liver function
  - Immune function and the gastrointestinal tract
  - Gastrointestinal dysfunction: diarrhoea
  - Gastrointestinal dysfunction: constipation
  - Gastrointestinal dysfunction: gastric hypomotility and vomiting
  - Acute gastrointestinal haemorrhage
  - Acute liver failure
  - Pancreatitis I
  - Pancreatitis II
  - Nutrition: assessment
  - Nutrition: enteral
  - Nutrition: enteral feeding complications
  - Nutrition: enteral feeding tube types
  - Nutrition: feeds and daily requirements
  - Parenteral nutrition: care of the patient
- Chapter 16 Systemic inflammatory response syndrome, sepsis, and multiple organ dysfunction
  - Chapter 16 Systemic inflammatory response syndrome, sepsis, and multiple organ dysfunction
  - Introduction and definitions
  - Overview of physiology
  - Organ manifestations of SIRS/sepsis I
  - Organ manifestations of SIRS/sepsis II
  - Principles of management of sepsis
  - Early goal-directed resuscitation
  - Ventilatory management
  - Supportive management
- Chapter 17 Trauma
  - Chapter 17 Trauma
  - Initial management
  - Nursing assessment
  - Head injuries
  - Maxillofacial injuries
  - Spinal injuries
  - Chest injuries
  - Abdominal and pelvic injuries
  - Intra-abdominal hypertension
  - Genitourinary injuries
  - Musculoskeletal injuries
  - Complications following trauma
  - Burn injuries
  - Near drowning
  - Hypothermia
- Chapter 18 The major incident and critical care
  - Chapter 18 The major incident and critical care
  - Setting up systems for response
  - Staff training and preparation
  - Blast injury
  - Serious infectious epidemics
- Chapter 19 Haematology
  - Chapter 19 Haematology
  - Blood cells: types, terms, and normal values
  - Erythrocyte disorders
  - Leukocyte disorders
  - Thrombocyte disorders
  - Anticoagulation therapy
  - Clotting disorders
  - Blood and blood component products
  - Adverse reactions to blood transfusions
  - Hazards of blood transfusions
  - Haematological malignancy
- Chapter 20 Immunological disorders
  - Chapter 20 Immunological disorders
  - Organs and cells of the immune system: an overview
  - The immunocompromised patient
  - Human immunodeficiency virus
  - Systemic lupus erythematosus (SLE)
  - Rheumatoid arthritis
  - Vasculitic disorders
  - Anaphylactic and anaphalactoid reactions
- Chapter 21 Metabolic disorders
  - Chapter 21 Metabolic disorders
  - Phaeochromocytoma
  - Addison’s disease
  - Hypothyroidism: myxoedema
  - Hyperthyroidism: thyrotoxicosis
  - Hypocalcaemia
  - Hypercalcaemia
  - Diabetic ketoacidosis
  - Hyperosmolar, hyperglycaemic states
  - Hypoglycaemia
  - Diabetes insipidus (DI)
- Chapter 22 Obstetric emergencies
  - Chapter 22 Obstetric emergencies
  - Pre-eclampsia and eclampsia
  - Massive obstetric haemorrhage
  - Amniotic fluid embolism (AFE)
  - HELLP syndrome
  - Cardiac arrest in the pregnant patient
  - The pregnant patient in the critical care unit
- Chapter 23 Poisoning
  - Chapter 23 Poisoning
  - General principles
  - Management of poisoning
  - Toxidromes
  - Salicylate poisoning
  - Paracetamol poisoning
  - Carbon monoxide poisoning
  - Tricyclic antidepressant poisoning
  - Illicit drug overdose
- Chapter 24 Evaluating the effects of critical care
  - Chapter 24 Evaluating the effects of critical care
  - Evidence-based care
  - Monitoring the impact of critical care
  - Evaluating cost and outcome in critical care
  - Ethical issues in critical care
  - Mental capacity and advanced directives
  - Follow-up and long-term problems
- Index
  - Index

The Oxford Handbook of Critical Care Nursing provides nurses working in critical care with an easily accessible guide to the knowledge and nursing care skills needed in critical care. Patient-centred, this is the essential practical resource for all nurses working in critical care.

About the Authors

Sheila K Adam, Head of Nursing, Specialist Hospitals, University College London Hospitals, NHS Foundation Trust, UK,

Sue Osborne, Independent Consultant, UK

Disclaimer: Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.

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