Abstract

Aim. The purpose of this paper is to introduce the herbal medicines used for cardiovascular diseases and patient education about these drugs.

Method. This study was a systematic review of herbal medicines used for cardiovascular diseases. Herbal medicines were extracted from databases PubMed, Science Direct, and Highwire (Website of Stanford University) using search keywords Herbal, Hyperlipidemia, Heart failure, Cardiovascular and Hypertension. To describe the effective herbal ingredients, side effects, interactions, and patient education, a nursing book on herbs (Kostka et al, 2005) and the Comprehensive Atlas of Medicinal Plants (Stephen et al, 2004) were used.

Findings. Herbal drugs used for cardiovascular diseases in Iran consist of Antum, Alicom, Diuretic, Olea-crat, Crataegus Microphylla and Cratagus.

Conclusion. Some of cardiovascular diseases can be controlled by herbal drugs. Patient teaching about precaution, interaction and avoidance of arbitrary use of drugs are important.

Abstract

Aim. The purpose of this paper is to describe different types of primary triage methods that are common and applicable in disaster scene in order to familiarize medical team personnel with these methods.

Background. Disaster occurrence is rising all over the world. Primary assessment, treatment and transfer of victims to the medical centers which are away from the disaster scene is important considerations for first responder teams in response phase of disaster management cycle. In this regard, triage is an efficient tool for mass casualty management for which different strategies have been recommended in various countries.

Method. In this review, published articles from 1995 to August 2013 were searched in Ovid, Science Direct, Google Scholar and PubMed data bases by using the keywords Triage, On-scene and Disaster.

Findings. Based on search strategy, 50 English articles were found. Finally, 6 commonly adults triage methods and 2 pediatric triage methods were chosen to be described in this paper.

Conclusion. Regarding the sudden nature of disaster and creating chaos following them, it is necessary for medical team members to apply the appropriate tools for managing mass casualties in attention to limited resources and the large number of victims. In order to perform proper triage method and reduce the amount of error in this procedure, it is necessary to educate correct practices of applicable triage methods to medical team members, Red Crescent workers and volunteers.

Abstract

Aim.The aim of this study was a review on common pain assessment tools which are used in critical care units.

Background. Pain is an unpleasant physiological and psychological feeling and a complex phenomenon which is common among patients in critical care units. Nowadays, the importance of pain is to the extent that the American Pain Association named it as the fifth vital sign. Pain relief is an important issue to improve patient outcomes in the intensive care units. Accordingly, nurses must be sensitive in precise pain assessment.

Method. In this review article, six pain assessment tools were selected based on the keywords "pain", "pain relief", and "pain assessment tools" from the databases Ovid, PubMed, Cochran, CINHAL, Science Direct, Scopus, and Google Scholar. 

Findings.Among articles on pain assessment tools, 40 articles were selected. There are six commonpain assessment toolsused in critical care units includingCritical Pain Observation Tool (CPOT),Behavioral PainScale(BPS), behavioralpain assessmenttool(FLACC), Non-VerbalPainScale)NVPS), Pain Assessment and Intervention Notation (PAIN) algorithm and Nonverbal Pain Assessment Tool (NPAT) which are used in adult and pediatric patients with verbal impairment and for painfulprocedures.

Conclusion. According to the importance of pain management in intensive care units,   nurses must particularly apply valid tools for pain assessment to facilitate healing process and use of pain medications properly.

Abstract

Aim.The aim of this literature review was to study medical staff knowledge about cardiopulmonary resuscitation for pregnant women.

Background.Cardiopulmonary resuscitation (CPR) in pregnancy is a rare event. Although rare, CPR during pregnancy is very important, because saves the life of the mother and fetus. Knowledge of medical staff and their formal training on CPR in pregnancy are such factors affecting the maternal and fetal outcomes. Knowing the state of medical staff knowledge in this area will help recognize the existing gaps and plan for improvement.

Method.In this narrative review, databases such as Medline, Science direct, Ovid, Scopus, SID, Magiran and Barakat Knowledge Network System was used to data collection. Articles published between 2000-2016, were searched out by the keywords "cardiopulmonary resuscitation",‌"pregnancy", "knowledge","medical Staff", both inPersian and English. Inclusion criteria was content similarity to subject under study. 

Findings. Out of 20 retrieved papers, 4 cross- sectional analytical articles published between 2008-2012 was selected and reviewed for describing the state of medical staff knowledge on CPR in pregnancy. The knowledge of medical staff was in poor level in different areas such as proper pregnant patient positioning during CPR, sequence of bag- mask ventilation and intubation, defibrillation (application during pregnancy, paddle placement location, energy and considerations), the use of drugs and therapeutic doses and cesarean section in within 4-5 minutes following CPR failure.  

Conclusion.The knowledge of medical staff about CPR in pregnancy is poor. Establishing continuous educational course to improve their knowledge is recommended. 

Abstract

Aim. The aim of this study was to examine the effect of music therapy on ventilation criteria in mechanically ventilated patients in the intensive care unit.

Background. Complications made by mechanical ventilation are so much and considerable. Improvement of ventilation criteria is one of the factors that facilitatesweaning from mechanical ventilation.

Method. This randomized controlled trial was conducted in intensive care units of a teaching hospital affiliated to Iran University of Medical Sciences, Tehran, Iran. Seventy patients were recruited based on inclusion criteria and randomly allocated to experimental (n=35) and control (n=35) groups. For experimental group, relaxing music therapy was played with headphone for 30 minutes, once in the morning and once in the afternoon for one day. For control group, headphone was used without music for 30 minutes, once in the morning and once in the afternoon for one day. In both groups, ventilation criteria of respiratory rate, peak airway pressure and arterial saturation of oxygen (SaO2) were recorded in four intervals. Data analysis was performed in SPSS version 18 using statistical test.

Findings. Comparing of trends of ventilation criteria in experimental group showed that music therapy significantly reduced the mean respiratory rate (p= 0.0001), while in the control group, the mean respiratory rate slightly increased with time. In experimental group, the mean airway pressure reduced significantly within 30 minutes (17.30±3.65) compared with the time zero (19.68±3.64) (p=0.001). In the control group, the mean airway pressure increased slightly. The amount of spo2 did not differ significantly between experimental and control group (P=0.051).

Conclusion. Implementing music therapy in mechanically ventilated patients admitted to intensive care unit can reduce respiratory rate and maximum airway pressure. These could reduce the work of breathing and facilitate weaning the patient from ventilators.

Abstract

Aim. The aim of this study was to review studies about advantages and disadvantages of transradial and transfemoral coronary angiography. Transradial coronary angiography procedure is newer than transfemoral approach and inadequate knowledge and experience in this area needs to be considered for minimizing possible complications. 

Background. An increasing trend of cardiovascular diseases is of great importance. Although any different methods have been suggested for diagnosing coronary artery diseases, but coronary angiography remains as the best diagnostic and therapeutic method. Transradial and transfemoral coronary angiography as two approaches for diagnosing coronary artery diaseses have their own advantages and disadvantages.

Method. In this review study, various databases such as Google Scholar, PubMed, AHA journal and Elsevier were searched out by Persian and English forms of the keywords “Transradial coronary angiography”, “Transfemoral coronary angiography”, “Nursing care in coronary angiography” and “complications of coronary angiography”.

Findings. The findings are presented as follows: Comparison of the advantages and disadvantages of both radial and femoral approach, nursing care in radial angiography procedures and comparing patients’ satisfaction of experiencing radial or femoral angiography.

Conclusion. If the preparation and care before, during and after coronary angiography is properly settled and there is trained staff and physicians, it is suggested to use transradial approach for coronary angiography because of its fewer side effects and greater convenience the patients have with.

Aim. This study was conducted to evaluate the readiness of intensive care units of hospitals affiliated to Iran University of Medical Sciences for the implementation of family-centered care in 2017.

Background. Patients in the intensive care unit often are not able to participate in therapeutic decisions, therefore, involving families in decision-making process, implementation and treatment processes, and meeting the their needs improves treatment outcomes and increases patient and family satisfaction. Family-centered care is one of the means of providing care that recognizes and respects the vital role of the family.

Method. This was a descriptive cross-sectional study in which all of the intensive care units in the hospitals of Iran University of Medical Sciences were studied in terms of their preparedness for family-centered care. Proportionate stratified sampling method was used to recruit nurses, and the physicians were recruited based on convenience sampling. In order to investigate the structure and facilities, through a census of all specialized departments of hospitals affiliated to Iran University of Medical Sciences, a checklist was filled out. Data were analyzed in SPSS software version 22 using descriptive and inferential statistics.

Findings. According to the results, 60.9% of nurses were opposed to implementing family-centered care and have a negative attitude, and 57.3% of physicians agreed to implement family-centered care. There was a statistically significant difference between the attitudes of nurses and doctors (p≤0.0001). Also, the overall scores obtained from hospitals affiliated to Iran University of Medical Sciences showed that the facilities and hospital structure were poor for implementing family-centered care. 

Conclusion. Differences in the attitudes of nurses and physicians about family-based care showed the need for clarifying the concept of family-centered care. The implementation of family-centered care requires structural changes and extensive equipment in accordance with the standards.