Travel Distance Between Participants in US Telemedicine Sessions With Estimates of Emissions Savings: Observational Study.

Background: Digital health and telemedicine are potentially important strategies to decrease health care's environmental impact and contribution to climate change by reducing transportation-related air pollution and greenhouse gas emissions. However, we currently lack robust national estimates of emissions savings attributable to telemedicine.

Objective: This study aimed to (1) determine the travel distance between participants in US telemedicine sessions and (2) estimate the net reduction in carbon dioxide (CO) emissions attributable to telemedicine in the United States, based on national observational data describing the geographical characteristics of telemedicine session participants.

Risk Stratification in Noninvasive Respiratory Support Failure: A Narrative Review.

Topic/clinical Relevance: The use of noninvasive respiratory support, including noninvasive ventilation and high-flow nasal cannula therapy, has increased over the years. Failure of noninvasive respiratory support, defined as the need for invasive mechanical ventilation, increases the mortality rate.

Purpose: To familiarize critical care nurses with available risk stratification assessments and identify common concepts and limitations.

Oral Care in Critically Ill Patients Requiring Noninvasive Ventilation: An Evidence-Based Review.

Topic: Hospital-acquired pneumonia commonly develops after 48 hours of hospitalization and can be divided into non-ventilator-acquired and ventilator-acquired pneumonia. Prevention of non-ventilator-acquired pneumonia requires a multimodal approach. Implementation of oral care bundles can reduce the incidence of ventilator-acquired pneumonia, but the literature on oral care in other populations is limited.

Hemostatic Disorders: Physiology, Diagnostics, and Management.

A defect in any step of hemostasis can lead to potentially catastrophic results. The purpose of this article is to review hemostatic physiology, laboratory studies, and management of platelet and coagulation disorders to familiarize the advanced practice RN (APRN) with this often overlooked but critical system. Learning the underlying mechanisms allows for better understanding of the various disease states that can occur in the hematology and oncology settings.

Readiness Assessment for Extubation Planning in the Intensive Care Unit: A Quality Improvement Initiative.

Background: Extubation failure is the reintubation of patients meeting criteria for weaning from mechanical ventilation. Extubation failure is correlated with mortality, prolonged mechanical ventilation, and longer hospital stays. Noninvasive ventilation or high-flow nasal cannula oxygen therapy after extubation is recommended to prevent extubation failure in high-risk patients.

Hypopituitarism: Case Study Involving Hypernatremia Prompting Discovery of a Pituitary Disorder in a Patient With Lymphoma.

Background: The endocrine system contributes to numerous physiologic processes. Compensatory mechanisms are in place that can assist when endocrine dysfunction occurs, which may make it difficult to identify pathologic states.

Objectives: The case study in this article presents a 74-year-old woman with diffuse large B-cell lymphoma who was admitted to an oncology critical care unit with neutropenic fevers and suspicion of gastrointestinal bleeding.