Children undergoing heart surgery need strong sedation and pain medications. Weaning them off these medications is complicated; many have withdrawal symptoms that require additional medications. Unfortunately, says Patricia Lincoln, RN, MS, CCRN, CNS-BC, “the medications we use to manage withdrawal may keep patients in the hospital longer.”
Last spring, Lincoln and her nursing colleagues in the Boston Children’s Hospital Cardiac Intensive Care Unit (CICU) launched an initiative called Cardiac RESTORE to help wean patients from pain and sedation medications according to a carefully designed algorithm.
“Cardiac RESTORE helps us continually assess what patients need and regulate their physiologic response to changes,” says Lincoln. “Medication doses are constantly being titrated or weaned unless the patient has an acute deterioration.”
Early results show decreased usage of pain and sedation medications with no ill effects. …
Check the nutrition label on just about any packaged food, and you’ll see how much carbohydrate or salt, or how many calories, are lurking inside waiting for you. But that label won’t give you the whole nutritional picture. How much magnesium does your bag of chips contain? Or iodine, or copper?
These elements are all on the list of human micronutrients: nutrients that help maintain many of the critical biochemical processes within our cells. And while we only need them in very small amounts, micronutrient deficiencies can be devastating, even fatal.
Most of us get the micronutrients we need from our diet (chips aside), but for children whose digestive tracts can’t process regular food – such as those with intestinal disorders like short bowel syndrome (SBS) – getting the right amount of micronutrients is a different story. These children often often have to get all their nutrition intravenously through a process called parenteral nutrition (PN).
Since dieticians can tailor the nutrients given to a child on PN, you’d think that it would be easy to get the right amount of micronutrients, like copper, into the mix. But that isn’t necessarily so. …