Biomedical subjects
Publications and source records attributed to Brendan Docherty.
This is the first in a series of three papers that aim to explain the anatomy and physiology related to cardiac conductivity and to describe some common and less common arrhythmias that ward nurses may come across. This first paper examines the background to ECG monitoring, the anatomy and physiology of the heart and ECG recording and interpretation.
The second of three papers on interpreting ECGs will examine atrial arrhythmias. These are abnormalities of the heart that occur in one of the two upper chambers, the left or right atrium. The patient may present with atrial ectopics, fibrillation, flutter or tachycardia. This paper will look at the signs, symptoms and management of patients with this arrhythmia.
In the third and final paper in this series on the interpretation of electrocardiograms we look at ventricular and atrioventricular arrhythmias. This paper complements and builds upon cardiac rhythm recognition discussed in the two previous papers and presents some of the more life-threatening arrhythmias that nurses may come across in ward environments.
Nurses need to be aware of the physiological aspects of fluid homeostasis and the nursing care and management required to manage patients with fluid balance problems effectively. This paper examines fluid management for patients with hypovolaemia, and provides reflective study points to encourage nurses to investigate the issues further.
Cardiopulmonary arrest is a common and treatable cause of premature death. This Factfile discusses basic life support and automated external defibrillation.
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Anaphylaxis and anaphylactoid reactions can lead to asphyxia, shock and ultimately cardiorespiratory arrest.
Tracheostomies were once rarely seen outside critical care settings but are now more commonplace among patients nursed in general wards. This paper aims to provide nurses with some background information on the need for good tracheostomy care and practical clinical guidance on how to care for a patient with a tracheostomy in a safe and effective manner.
This article, the first of two parts, aims to develop core cardiovascular and respiratory knowledge and to enhance practice for the practitioner caring for an acutely ill patient on a general ward setting. The second part will focus on advanced cardiorespiratory assessment. With increasing acuity of illness in general ward settings, patients' needs are becoming more complex in terms of their nursing and medical management. Nurses must be able to respond to subtle clinical signs and symptoms and act appropriately to ensure that a safe, patient-focused environment is maintained and that the care delivered is evidence-based. By increasing knowledge of the theory and practice of nursing physical assessment, and the ensuing management, acutely ill patients nursed in general ward areas may be provided with timely and appropriate care and may avoid further deterioration and an intensive care admission. This article describes core physical assessment skills, the normal physiology of the cardiovascular system, and the management of cardiovascular and respiratory dysfunction.
The second of this two-part article aims to develop advanced cardiovascular and respiratory knowledge to enhance practice for the nurse caring for an acutely ill patient on a general ward. The first part dealt with the core aspects of care in respiratory and cardiovascular physical assessment, including respiratory function and failure, pulse oximetry, oxygen therapy, fluid therapy, pulse measurement, blood pressure and electrocardiogram monitoring (Vol 11(11): 750-8). As the use of critical care beds within trusts becomes more difficult to manage, with ever-increasing patient dependency and occupancy figures remaining high, critically ill patients are likely to remain in wards longer or be discharged from a critical care environment earlier. These patients will require more frequent, direct, non-invasive and invasive monitoring to ensure that they do not deteriorate, and that any deteriorations are detected early and managed effectively. The skills and information discussed here will help nurses advance their practice and improve the quality of their care.