Bold Voices - March 2013 - (Page 11)

AT THE BEDSIDE New STEMI Guidelines Focus on Symptom Recognition, Ease of Use Newly released ST-elevation myocardial infarction (STEMI) guidelines are easier to follow and put greater emphasis on improving symptom recognition and cardiac rehabilitation, says James Fang, a member of the guidelines’ writing committee. Fang, a physician at University Hospitals Case Medical Center, Cleveland, says the 2013 ACCF/AHA guidelines for STEMI management — published online in Circulation — get “quickly to the bottom line” and focus on what people are going to use. “It can be as authoritative as any document, but if nobody is going to bother picking it up, then we really haven’t succeeded in our purpose,” he adds in a report in Heartwire. Key points include improving recognition of heart attack symptoms and advising that ambulance personnel conduct ECGs in the field for faster triage and treatment. “We can’t open a vessel until the patient is identified,” Fang says, “and one of the greatest delays in the management of this particular condition is time to recognition.” Therapeutic hypothermia is more strongly endorsed than ever for patients who become unconscious, although Fang cautions more details need to be ironed out, including the degree of hypothermia. The guidelines place an overriding emphasis on post-hospital care, including ensuring referral to cardiac rehabilitation with a focus on exercise, smoking cessation, diet and other factors. Therapeutic hypothermia is more strongly endorsed for unconscious patients. For additional information about hypothermia, access the continuing nursing education article “Induced Moderate Hypothermia After Cardiac Arrest” at /hypothermia. Low Levels of Vitamin D Linked to Longer Life Span L ow levels of vitamin D in middle-aged children of parents in their 90s may be associated with longevity, finds a study in (CMAJ) Canadian Medical Association Journal. Past studies have linked low levels of vitamin D to illnesses such as diabetes, allergies and heart disease. But it was never proven whether low vitamin D levels were the cause of illness, or if they were a consequence. Researchers from the Department of Gerontology and Geriatrics at Leiden Study accounts University Medical for other factors Center in The Netherlands turned that also influence to the Leiden vitamin D levels. Longevity Study, which has enrolled more than 400 families with at least two siblings who lived into their 90s. “Levels of 25-hydroxyvitamin D in Familial Longevity: the Leiden Longevity Study” includes the siblings and their offspring as well as their offspring’s partners to understand the role of genetics and the environment. After accounting for other factors that also influence vitamin D levels, such as age, body mass index, sex, kidney function and supplement use, they found an association between low vitamin D levels and familial longevity. The study also finds that “offspring had a lower frequency of common genetic variants in the CYP2R1 gene; a common genetic variant of this gene predisposes people to high vitamin D levels.” Critical Care RNs Want a change from the bedside and greater flexibility? Ever wonder what it would be like to travel, explore new environments, and meet and train peers? Traveling Clinical Consultants/Educators needed for Medical Device education/support CSA provides and manages resources for several cutting edge medical device companies (pt monitoring, IV pumps, etc.). We are not a recruitment agency. Visit for more information about our company. Requirements include: Professional RN (BSN not req’d), 3 recent years of ICU, CCU, PICU or ED experience, HIGH level of initiative/accountability, interpersonal and presentation skills, computer and MS Office Suite application experience. Must live close to a major US airport for travel requirements and commit to 10 days of availability per month (with a commitment of 4-5 days per assignment, Monday through Friday, at least 2 weeks per month.) To be considered for this opportunity, send your resume to: AACN BOLD VOICES MARCH 2013 11

Table of Contents for the Digital Edition of Bold Voices - March 2013

Front/Digital Edition Viewing Guide
Another Angle
Design an NTI Just for You
New Guidelines Set Practice Framework for Tele-ICU NursingPractice
New Methods Increase Speed of Sepsis Diagnosis
High Blood Pressure Can Injure the Brain of Young Adults
Recurrent Hypoglycemia May Not Impair Long-Term Development of Preterm Infants
Superstorm Sandy Hospital Evacuation Decisions Questioned
New STEMI Guidelines Focus on Symptom Recognition, Ease of Use
Early Communication About Resuscitation Improves EOL Quality
Vote Now for AACN Board, Nominating Committee Members
Simple Measures Reduce Pneumonia
Fresh Blood in the ICU
Meeting Veterans’ Healthcare Needs
In Our Journals
Checklists May Reduce Venous Thromboembolism
Certification Capsules
Chapter Leadership Workshop @NTI 2013
Wear Your NTI Pride on May 20
Dare To

Bold Voices - March 2013