Treating a Patient with an Intestinal Obstruction
By Vicky P. Kent RN, PhD,CNE

An intestinal obstruction is anything that occludes, retards, or alters the progression of solids and liquids through the small and large bowel. Patient treatment may range from medical remedies to surgery. A variety of causes and/or conditions could precipitate a bowel obstruction at any point of the life cycle. The patient’s age determines the set of factors that contribute to bowel obstruction. Appropriate patient care depends upon accurate diagnosis of the particular obstruction.

Closed Enteral Feeding Systems
By Mary Theresa Lau, RN, MS, CNS, CNSN, CRNI

Enteral nutrition has been utilized as a medical therapy for many years. Since ancient times, patients unable to consume adequate nutrients from food were given liquids via glass and wooden tubes. As this was cumbersome and dangerous, the method was not often used until the 18th-19th century.
With the advent of parenteral nutrition in the late 1960’s, enteral nutrition fell out of favor. Not until studies in the 1990’s-2000’s showed improved patient outcomes with enteral nutrition, did it develop to the point we have today.1 The introduction of closed enteral feeding systems in the late 1990’s led to improved safety and enhanced outcomes.

Preventing Ventilator-Associated Death
and Injury
By John Davies MA, RRT, FAARC

Mechanical ventilators provide valuable life supporting therapy. However, if proper attention is not paid to their functionality, they have the potential to harm or even contribute to patient deaths. Many factors exist that can influence the patient-related functionality of the ventilator. By identifying these factors, appropriate strategies can be developed to maximize the therapeutic potential while at the same time minimizing the potential for clinical misadventures.

Using an Evidence-Based Framework for Preventing Unplanned Extubation
by Jan Foster, PhD, RN, CNS, CCRN

Unplanned extubation (UE) can be a devastating event for critically ill patients, with potentially life threatening complications including airway trauma, bronchospasm, severe hypoxemia, and cardiac arrest. UE can lead to an increased number of ventilator days, resulting in excessive resource use for patients, and increased risk of litigation for healthcare professionals. Methods to protect against UE include education, quality improvement processes, sedation protocols, physical restraints, and tube securing methods.