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Full-Text Articles in Medicine and Health Sciences
Reducing Emergence Delirium In Combat Veterans Through The Development Of A Decision-Tree Utilizing Ketamine And Precedex, Joseph Oldani, Russell Arendt
Reducing Emergence Delirium In Combat Veterans Through The Development Of A Decision-Tree Utilizing Ketamine And Precedex, Joseph Oldani, Russell Arendt
Doctor of Nursing Practice Projects
Emergence Delirium incidences in the combat veteran population warrant unique anesthetic considerations. Examples of these considerations include the exclusion of a benzodiazepine and the use of low dose Ketamine or Precedex infusions. Researching these considerations, an anesthetic decision tree coupled with a screening questionnaire was developed and implemented in a hospital in Southern Illinois. The tool was developed based on a thorough literature review and a need to condense this information into a working knowledge for clinical application. Implementation of the project included staff education on the tool and the management of Emergence Delirium by using Ketamine and Precedex. A …
Implementation Of Provider Education For A Subanesthetic Ketamine Infusion For Acute Analgesia In Opioid Tolerant Postpartum Patients, Leah Baecht
Doctor of Nursing Practice Projects
The current opioid epidemic demands the development of new management policies and staff education to increase awareness of issues and improve care of patients with Opioid Use Disorder (OUD). A recent dramatic increase in OUD during pregnancy has paralleled the epidemic observed in the general population. The combination of OUD and cesarean delivery, place both the mother with OUD and neonate at risk for increased postoperative complications. The purpose of this project was to evaluate and increase staff knowledge regarding OUD in obstetrics. An analysis of staff knowledge was performed via surveys both pre and post dissemination of evidence. The …
Improving Acute Pain Management For Pediatric Patients: Development Of A Ketamine Infusion Protocol, Oksana Koeppen
Improving Acute Pain Management For Pediatric Patients: Development Of A Ketamine Infusion Protocol, Oksana Koeppen
Doctor of Nursing Practice Projects
Multimodal analgesia is a recommended approach for acute pain management for adults and children (ASA, 2012; Chou et al., 2016). This approach is becoming a prominent modality in pain control strategies in the pediatric population. An intravenous anesthetic, ketamine, may be a useful adjunct for acute pain management in children. Development of a pediatric ketamine infusion protocol and its subsequent introduction to the key stakeholders at the host facility in central Illinois were the focus of this project. Research has demonstrated the effectiveness of low-dose intravenous ketamine in acute pain management when used as an adjunct to other medications (Asadi …
Developing A Ketamine Infusion Protocol To Treat Complex Regional Pain Syndrome, Nikolas M. Kozul
Developing A Ketamine Infusion Protocol To Treat Complex Regional Pain Syndrome, Nikolas M. Kozul
Doctor of Nursing Practice Projects
Complex Regional Pain Syndrome (CRPS) has been studied under different names dating back to the American Civil War. Despite being studied for over 100 years, CRPS is still not a very well understood disease process and there is no consensus on the best way to treat it (O’Connell, Wand, McAuley, Marston, & Moseley, 2016). One treatment that has shown to be effective in reducing pain scores in patients with chronic CRPS is a multiple day infusion of ketamine (Sigtermans et al., 2009). The purpose of this doctor of nursing practice project was to develop a ketamine infusion protocol for anesthesia …
Improving Acute Postoperative Pain Management For Opioid-Tolerant Patients: Development Of A Postoperative Ketamine Infusion Protocol, Jeri Dockins
Doctor of Nursing Practice Projects
Anesthesia providers are encountering a growing number of opioid-tolerant patients. To date, the treatment for acute pain has been the administration of opioids. The administration of opioids leads to postsurgical complications. This project’s purpose was to improve acute pain management for opioid-tolerant patients by creating a postoperative ketamine infusion protocol. Ketamine is a noncompetitive antagonist at N-methyl-D-aspartate receptor sites involved in nociceptive and inflammatory pain transmission (Radvansky et al., 2015; Vandivelu et al., 2016). Research has demonstrated ketamine administered as a bolus dose or a continuous low-dose infusion for 24 to 48 hours postoperatively often results in a decrease in …