J Ayub Med Coll Abbottabad 2005;17(4) COMPARISON OF METOCLOPRAMIDE, PROCHLORPERAZINE AND PLACEBO IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING (PONV) FOLLOWING TONSILLECTOMY IN YOUNG ADULTS Muhammad Jamil, Syed Mushtaq Gilani, Shamsher Ali Khan Department of Anaesthesiology, Ayub Medical College and Teaching Hospital, Abbottabad Background: Postoperative nausea and v
Copy of summer 2006 newsletter caccn.pubCACCN NEWSLETTER
Inside this issue:
Message from the President
A Little of That Down East Feeling
Well, it is hard to believe that the long hot days of summer have come and gone. All that remains are the flowers as little reminders of the beautiful summer evenings that we will be missing. The fall colors are in full bloom outlining the streets of Scarborough. Today we saw snow flurries. Other areas of the country saw more. We all know what that means. At CACCN, fall is all about Evolutions and the anticipated excitement of attending Dynamics 2006. Critical care nurses from across Canada come together to network, and to build knowledge on what is new and evidence- This year Dynamics 2006 was held in beautiful St. John’s, NL, one of the old- est cities in North America. In the movie, “Field of Dreams”, they said if you build it, they will come and they did indeed. They came in droves as predicted to make their own waves in St. John’s. More than 423 critical care nursing CACCN Toronto
delegates from across Canada converged upon St. John’s for Dynamics 2006, Executive 2006/2007
the annual conference of the CACCN held during September 24th-26th. The conference theme, “Families, Treasures, Generations: Riding the Waves of President
Critical Care”, captures the evolving role of family and health care in collabo- Past President
ration towards a common goal to promote quality care. Dynamics 2006 proved to be very interesting and informative. The President elect
conference provided a wide range of educational opportunities for delegates to review, learn, laugh, dance and relate stories to other critical care nurses. Secretary
Opportunities range from poster presentations, concurrent sessions and key- note sessions. Topics focused on the clinical and leadership roles nurses as- Treasurer
sume in their work environment such as helping families in crisis, caring for the septic patient and focusing on the ethical issues of family-centered care in Newsletter Editor
critical care. Other topics addressed the role of the rapid response team, car- ing for the elderly in critical care, PA lines, surviving sepsis and moving evi- Publicity
The keynote addresses were especially compelling. Sister Elizabeth talked about the changing face of health care. Brenda Morgan talked about Education
how nursing impacts patient outcome. Leaders can be anyone. They can lead Lynette Hoeppler
from anywhere even at the bedside. Leadership is best demonstrated when Paediatric Consultant
the nurse uses this power effectively and demand excellence in patient care. Sherry Rumbolt, another speaker, a nurse and mother shared her life experi- Membership
ences as a Newfoundlander. She says that we can be and do anything we want Conference Chair
Message from the President (cont’d)
At the end of the day all you need to be is validated. Geoff Eaton, founder of Real-time Cancer, shared his story, his journey after being diagnosed with Leukemia in 1998 and how he dealt with a cancer relapse in 2001. Geoff turned his problems around by focusing his energies to educating and helping other young people with similar problems to cope. For many nurses, it was not all work and no play. Judging by the stories they had to share, they did take time out to visit some of the historical landmarks, points of interest, and take in the nightlife. Sig-nal Hill and Cape Spear were listed among the top must see landmarks for the nurses to see. Many of them walked or drove. Some had some assist from the locals along Signal Hill. They went out in small boats for an afternoon tour in hopes of seeing an iceberg or whale or two but instead they saw the many wonders of the rising sea as it merges to meet with the sky. Imagine the difference by day and by night. At this time I would like to congratulate the Toronto Chapter of CACCN for a job well done. The Toronto Chapter of CACCN was named Chapter of the year and was awarded a plaque and $500.00 from the Sorin Group Canada. Congratulations Toronto Chapter of CACCN and conference team. Many thanks for your hard work. Thank you Toronto Chapter members and friends for your con-tinued support of our education sessions and workshops during the year. The conference, Evolutions, is next April at the Sheraton Parkway North Hotel. Other plans for workshops are in the works for next year. The Toronto Chapter of CACCN wil continue to offer educational sessions as our commitment to our vision to enhance nursing knowledge. Look forward to more workshops. Consult the Toronto Chapter website for more details of upcoming events. Please feel free to e-mail me with any questions. Be safe and take care. New!! Spotlight on. The Scarborough Hospital At the Toronto Chapter of the CACCN, we believe that we all learn by sharing knowledge whether it is across sites or between hospitals. Critical Connections, the chapter newsletter shares in this belief by spotlighting on what is happening in and around your units. The newsletter is taking on a different focus by spotlighting units in Toronto and surrounding areas. In this issue we are spotlighting what is happening at the Scarborough Hospital (TSH) and we will be featuring the happenings in other ICUs in future issues. We are interested in what are other hospitals doing. What are they doing about healthy workplace issues? Inquiring nurses want to know. The Scar-borough Hospital (TSH) is a busy community hospital. It remains a patient –focused organization that strives to improve patient care and develop partnerships in the community. Its ICU is a busy 14- bed closed unit that provides evidence-based best practice to medical and surgical patients who require intensive ongoing monitoring, assessment and treatment. Patient care is provided using a multidisci- plinary team approach supported by pharmacy, speech language pathologists, social work, nutrition, pastoral ser-vices, physiotherapy and 24- hour nursing, Intensivist and RT coverage. The ICU utilizes the state-of-the art technology and services, complex modes of ventilation, high frequency oscilla- tion, and CRRT with PRISMAFLEX technology. It supports the vascular surgical program, the regional dialysis pro-gram and the provincial CRITICALL initiative. In addition, the ICU participates in innovative research studies through data collection and knowledge transfer from the Performance Improvement Collaborative (PIC) regarding best practice results for DVT prophylaxis, daily spontaneous breathing trial, early nutrition practices, prevention of ventilator associated pneumonia and stress peptic ulcer prophylaxis. These days TSH is all excited. We are looking forward to a new Bigger, Better, Faster Emergency and Critical Care Center (ECCC). The TSH Horizons, the Scarborough Hospital employee newsletter highlighted the Septem- ber 21, 2006 groundbreaking event held near the main entrance of TSH general campus. The Honorable George Smitherman, Minister of Health and Long-term care, the TSH CEO, Dr. Hugh Scott and other special guests were at the groundbreaking ceremony for the new ECCC. Soon we can brag that we have the newest ECCC in the greater Toronto area. The ECCC is scheduled to open in 2009. As part of its organizational goals, TSH is commit-ted to improving patient care through a multidisciplinary implementation of six targeted interventions. These in- clude: Critical Care Response Teams, Improved care for AMI patients, Prevention of drug incidents and infections due to surgical sites, central lines and ventilator associated pneumonia. Implementation evolved from an April 2005 Safer Healthcare Now Campaign and a Canadian Adverse Events Study. TSH strives to improve the work- place by adopting the National Quality Institute Progressive Excellence Program (NQI) for health and wellness. TSH completed the commitment level of the program and won the Healthy Hospital Innovators Award. Most recently, TSH received funding from the Ministry of Health and Long Term Care for another round of “Late Career” initiatives. The goal is to keep nurses over 55 in the workforce by taking them away from the bedside for 20% of the time and getting them involved in other areas of nursing, therefore, giving nurses a different focus and a different challenge to boot. TSH is just buzzing with activity. We are interested in what is up in your institutions. Write to the Edi-tor at Critical Connections and tell us what is happening in your unit. Important Dates to Remember.
Mark your calendar!
February 14, 2007 Neuro/Renal/Endocrine Review for
CNCC exam (Brenda Morgan)
** see website for registration details** March 9th, 2007 Cardio Respiratory Review for CNCC
exam (Sandra Goldsworthy and Leslie Graham)
** see website for registration details** April 23, 2007 Evolutions Conference
October 21-23, 2007 Dynamics Conference Regina,
Ask the Expert!
Meet Vicky, our volunteer expert who answers your very important critical
Do you have a question to ask or a story to share
about your work?
Please drop a few lines to Vicky or e-mail via the Toronto Chapter website. We would love to hear
(Answers will be in the next newsletter)
a) delta wave b) shortened PRI c) prolonged QRS d) all of the above Test Yourself!!
(answers will be in the next newsletter)
2. Interpret this 12 Lead.
3. For the following match the drug to it’s action
____ nitroglycerine a) can cause confusion, prolonged QT ____ nitroprusside b)causes severe peripheral vasoconstriction at high doses ____ dobutamine c) inotropic, cardiac selective, vasodilates ____ dopamine d) venous vasodilator primarily ____ cardizem e) used in atrial fib and SVT ____ lidocaine f) refractory ventricular tachycardia and atrial fibrillation ____ amiodarone g) used in hypertensive crisis and cardiogenic shock
ARTICLE PROVIDED BY THE CENTER FOR ENDOMETRIOSIS CARE (CEC) Endometriosis in Teenagers by Robert B. Albee, MD The endometriosis patient who elicits from me the greatest form of empathy and compassion is the patient whose pain begins in her teenaged years or even earlier. This young woman has doubts and fears when she thinks her incapacitating symptoms are the norm. She believes that eve