1. Skitton, Ann MSN, RN, CCRN

Article Content

This issue of Critical Care Nursing Quarterly encompasses a variety of topics regarding caring for the patient experiencing cardiac-related crises. Schulenburg's article, "Management of Hypertensive Emergencies: Implications for the ICU Nurse, "clarifies the distinguishing features of a hypertensive emergency and a hypertensive urgency. An excellent discussion of pharmaceutical agents and their uses to avert end organ damage makes this article important reading for all critical care nurses. "Management of Acute Decompensated Heart Failure " by Varughese presents a succinct discussion of the pathophysiology of heart failure along with exacerbating factors that lead to decompensation. With a thorough understanding of the neurohormonal factors involved in this disease, the nurse is better equipped to participate in therapy and patient education. "Ventricular Assist Devices in the Adult " by Richards and Stahl discusses the rationale for using such adjuncts as a permanent means of support for heart failure patients who are not candidates for transplantation and outlines essential elements of nursing management. Although many critical care nurses do not regularly care for children, it is vital for everyone to understand the important distinctions associated with pediatric heart failure treatment. "Mechanical Circulatory Support for the Pediatric Patient " by Carberry Gunter, Gemmato, and Morales consider the challenges of clinical care as well as the human values inherent in caring for the child with a failing heart. Cushman, Warren, and Livesay enlighten caregivers about the role of induced hypothermia. Their article, "Bringing Research to the Bedside: Induced Hypothermia after Cardiac Arrest, " present case studies and research findings about this promising therapy and its role in improving neurological and mortality outcomes for select patients post-cardiac arrest. Statin therapy has


many promising uses beyond treatment of lipidemia, including management of acute coronary syndrome, as an adjunct to percutaneous coronary intervention and for sepsis prevention. Kronmann, Hatfield, and Kronmann's article, "Statin Therapy: Not Just Used to Lower Cholesterol? " is a must read for all critical care clinicians. Angerio, Bialko, and White's article, "C-Reactive Protein, Stroke and Statins, "considers the role of C-reactive protein as an early marker of inflammatory vascular disease. The authors suggest a central role for C-reactive protein in certain strokes and demonstrate the prophylactic benefits of statin therapy. Shindler retools the clinician in his work, "Practical Cardiac Auscultation. "Although the stethoscope is an everyday tool in critical care, few know the nuances of its use that can make it even more valuable for patient assessments.


Two articles included in this issue are not necessarily related to cardiac care. Their messages relate to all clinicians. Fry and Warren's research, "Perceived Needs of Critical Care Family Members: A Phenomenological Discourse, " will help nurses appreciate the unique experiences of those individuals who stay near the critical care units as patient support. Their findings reveal the elements that make a real difference in these individuals' level of confidence in the staff who are caring for their loved ones. Finally, Yates reports one hospital's use of bar coding as a safety measure in medication administration in her article, "St. Luke's Hospital, Chesterfield, Missouri: Case Study[horizontal ellipsis], "on implementing bar coding. For nurses who are not yet using this technology, they will gain an appreciation of its merits in patient safety and medication error reduction.


Ann Skitton, MSN, RN, CCRN


ICU Nurse Manager Shawnee Mission Medical Center Shawnee Mission, Kansas Issue Editor