Pain management is an essential element in the medical health system and in patient care. Medicine has advanced in uncovering the physiological process of pain, and more recently the underlying mechanisms of nociception have gained increasing attention in the medical community1,2.
Medtronic seeks to highlight the clinical relevance of intraoperative nociception and its management, and to enhance global awareness of this less considered aspect of pain.
Upper airway obstruction happens when there is an anatomic narrowing or occlusion that results in a reduced ability to exchange gas in and out of the lungs. The obstruction can lead to respiratory failure, arrhythmias, cardiac arrest or death within minutes. Therefore, healthcare professionals must be aware of signs and symptoms, possible causes and management in order to intervene promptly and minimise morbidity and mortality.
Bronchoscopy is an invasive procedure that allows the direct examination of the larynx, trachea and bronchi using either a flexible fibreoptic bronchoscope or a rigid metal bronchoscope.3,4 Nurses perform an important role supporting patients undergoing bronchoscopy. In this article, we review the role of the bronchoscopy nurse in 3 surgical stages.
In this article we review the tool LEMON which has been used in different clinical settings.
Around 1-1.5% of the population requires an upper or lower endoscopic investigation of the gastrointestinal tract each year.6 Gastrointestinal endoscopic procedures are used as diagnostic, as well as interventional. It includes gastroscopies where the scope is placed inside the oesophagus, stomach and first part of the small bowel; and colonoscopies where the scope is inserted in the large bowel. Nurse’s play an important role in these procedures. In this article we highlight the role of nurses in gastrointestinal endoscopy.
Chronic Obstructive Pulmonary Disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. It is currently the fourth leading cause of death in the world.7 An estimated 3 million people have COPD in the UK, of whom 2 million have undiagnosed COPD.8 It is responsible for over 30,000 deaths, 1.4 million General Practitioner consultations, a million hospital bed days and it costs the NHS over £800 million each year.9
1. Smith, S. J. Advances in understanding nociception and neuropathic pain. J. Neurol. 265, 231–238 (2018).
2. Gan, T. J. Poorly controlled postoperative pain : prevalence , consequences , and prevention. 2287–2298 (2017).
3. Martin, P. (2019) Bronchoscopy. Nurse Labs. Available at https://nurseslabs.com/bronchoscopy/
4. Martin, J. (2013) Preparing and supporting patients undergoing a bronchoscopy. Nursing Times. Available at https://www.nursingtimes.net/clinical-archive/respiratory-clinical-archive/preparing-and-supporting-patients-undergoing-a-bronchoscopy-14-10-2003/
5. Sepsis Research (2020) What is Sepsis. Available at https://www.sepsisresearch.org.uk/statistics/
6. Pauline Matthews (2001) Developing the role of the nurse endoscopist. Available at https://www.nursingtimes.net/clinical-archive/gastroenterology/developing-the-role-of-the-nurse-endoscopist-01-11-2001/
7. Global Initiative for Chronic Obstructive Lung Disease (2016) Pocket Guide to COPD diagnosis, management and prevention. Available at: https://goldcopd.org/wp-content/uploads/2016/12/wms-GOLD-2017-Pocket-Guide.pdf
8. NICE (2015) Chronic obstructive pulmonary disease. Available at: https://www.nice.org.uk/Media/Default/Standards-and-indicators/QOF%20Indicator%20Key%20documents/nm105-copd-guidance.pdf
9. Primary Care Respiratory Society UK (2013). Reviewing people with COPD. Available at: https://www.pcrs-uk.org/sites/pcrs-uk.org/files/os19_copd_review.pdf
10. Sullivan (2019) 5 things to know about capnography. EMS1. Available at https://www.ems1.com/ems-products/capnography/articles/5-things-to-know-about-capnography-Hr5ETRdXzCoU3fLH/
11. American Association of Sleep Technologists (2018) Technical Guideline End-Tidal CO2. AAST. Available at https://www.aastweb.org/hubfs/End-Tidal%20CO2%20-%20AAST%20Technical%20Guideline.pdf
12. Richardson (2016) Capnography for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings: A Health Technology Assessment. Canadian Agency for Drugs and Technologies in Health. Available at https://www.ncbi.nlm.nih.gov/books/NBK362376/
13. Epstein SK. How often does patient ventilator asynchrony occur and what are the consequences? Respir Care. 2011;56(1):25–38.
14. Puneet Katyal. Pathophysiology of Respiratory Failure and Use of Mechanical Ventilation. American Thoracic Society Available at https://www.thoracic.org/professionals/clinical-resources/critical-care/clinical-education/mechanical-ventilation/respiratory-failure-mechanical-ventilation.pdf
15. Lotia (2008) Anaesthesia and morbid obesity. Continuing Education in Anaesthesia Critical Care & Pain, Volume 8, Issue 5, October 2008, Pages 151–156 Available at https://academic.oup.com/bjaed/article/8/5/151/268305