Page 281 - Critical Care Nursing Demystified

266 CRITICAL CARE NURSING DeMYSTIFIED

KEY WORDS

ABCs – airway, breathing, circulation GCS – Glasgow Coma Scale
ACI – acute lung injury Golden Hour
AVPU – awake, verbal, pain, MVCs – motor vehicular crashes
unresponsive NIRS – near-infrared spectrometry
Circumferential burn PEA – pulseless electrical activity
Colloids Primary injury
Cricothyroidotomy Rapid IV infuser
Crystalloids RTS – revised trauma score
DPL – diagnostic peritoneal lavage Rule of Nines
EMS – Emergency Medical System Secondary injury
Eschar Sublingual capnometry
Fasciotomy 3:1 rule
FAST – focused assessment with Triage
sonography for trauma Trimodal Distribution Peaks

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In the background, one can hear the soft, musical refrains of “How Great Thou
Art.” Lily, who is 16, beautiful, and unresponsive, lies in her bed in the Neuro-
logical Intensive Care Unit surrounded by her loving parents. They have
requested that their daughter remain on life support until their son, who is in
the military, arrives home from Afghanistan in time to say goodbye.
Lily was on her way to the mall with a few classmates to shop for prom dresses.
On a cold, rainy day, the car she was a passenger in hydroplaned on a wet patch
and skidded into a tree. Her classmates were treated for minor injuries. Lily was
not so fortunate, and after 3 days her condition remained critical and unchanged.
In yet another bed in the same Neurological Intensive Care Unit, a grief-
stricken mother cries over her 16-year-old unresponsive son who was shot in
the head, the victim of a drive-by shooting.
Too often, the critical care nurse encounters these heart-wrenching dilem-
mas and it never gets easier. However, as these two teens face the end of life,
for all of the negative outcomes, positive outcomes in the care of trauma suf-
ferers are also beginning to emerge. More lives are being saved, as the time from
injury to definitive care has decreased and the methodology of care manage-
ment has improved, so that the patient has an increased chance of survival.