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February 20, 2014


Dear Colleague,

Mortality due to sepsis is as high as 50% and is the number one cause of death in the intensive care unit (ICU). The International Guidelines for Management of Severe Sepsis and Septic Shock were updated in 2012; they include several new emphases, which are summarized nicely in Get to Know the International Sepsis Guidelines (Nursing Made Incredibly Easy, 2013). One notable change is the focus on less use of blood products, both because of lack of demonstrated benefits and to minimize the risk of transfusion-related complications.

With regard to blood products, the recommendations are as follows:

  • Transfuse RBCs for hemoglobin < 7 g/dL to target a hemoglobin of 7 to 9 g/dL in adults.
  • Don’t use erythropoietin to reverse sepsis-associated anemia.
  • Don’t use FFP to correct lab clotting abnormalities unless active bleeding is present or a surgical intervention is planned.
  • Give FFP for platelet count of 10,000/mm3 or less in the absence of active bleeding or 20,000/mm3 or less if the patient has a high risk of bleeding.
  • Use higher platelet counts (50,000/mm3 or greater) for active bleeding, surgery, or invasive procedures to minimize the risk of hemorrhage.

You can read more about the campaign and about sepsis and septic shock by exploring the articles in More Resources.

 

Get to Know the International Sepsis Guidelines

Pediatric Sepsis: A Case Study

Improving Sepsis Outcomes for Acutely Ill Adults Using Interdisciplinary Order Sets

INSPIRING CHANGE: Sepsis: Recognizing the Next Event

Critically Ill and Septic Patient: Is Red Blood Cell Transfusion Adding to the Domino Effect?

What's new in sepsis?

Sincerely,




Lisa Bonsall, MSN, RN, CRNP
Clinical Edito
r


When it comes to end-of-life issues, ethical dilemmas can have a profound impact on us as individuals. The three CE articles in our new collection, Ethical Issues at the End-of-Life, can be read free on NursingCenter. For CE credit, you may take advantage of the special offer of 7.4 contact hours for $19.99.

AACN's Choosing Wisely list includes 5 evidence-based recommendations to help improve care and avoid unnecessary testing. As a NursingCenter member, you can access related content online from our journals FREE!

We are starting a new column on our blog titled "Nurses on the Move." Please enjoy this first post and get to know the exceptional nurses who work right here at NursingCenter.com! Other recent blog posts include Well done, CVS! and some select CE articles that we shared for World Cancer Day.

With the Olympics underway in Sochi, the spotlight is on traumatic brain injury.  Although the effects of concussion on pro football players has been widely studied and publicized, not much research has been done on the effects of multiple concussions suffered by snowboarders and skiers. We’d like to share this timely collection of traumatic brain injury articles published in the Journal of Trauma Nursing.


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Each year thousands of patients lose their lives as a direct result of preventable medical events. We must remain vigilant in eradicating these preventable occurrences that negatively impact our patients and work to improve patient safety and outcomes. Don’t miss Let's Talk About Safety! The 2014 Hospital National Patient Safety Goals.
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In Posttonsillectomy Pain in Children, the authors review the causes of posttonsillectomy pain, current findings on the efficacy of various pharmacologic and nonpharmacologic interventions, recommendations for patient and family teaching, and best practices for improving medication adherence.
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Currently, many providers treat hyperglycemia in the critically ill based on guidelines suggesting target glucose ranges between 140 and 180 mg/dL. However, recent literature has attempted to challenge this by comparing the effect of intensive insulin therapy (IIT) to conventional insulin therapy. Learn more by reading Glucose Management in Critically Ill Medical and Surgical Patients.
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Read the articles in the latest Featured Journal online only on NursingCenter. The Featured Journal gives you the opportunity to get acquainted with the kind of coverage and clinical information it has to offer. Get to know our journals. The current Featured Journal is...


The FDA has approved a new Boxed Warning for Cozaar (losartan) alerting health care providers that the drug should be discontinued as soon as possible when pregnancy is detected and that drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

The FDA has approved an expanded indication for Imbruvica (ibrutinib) to include the treatment of chronic lymphocytic leukemia patients who have received at least 1 previous therapy.

See more drug news.




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