Aynur Koyuncu

Effectiveness of local cold application on skin burns and pain after transthoracic cardioversion

Background Transthoracic cardioversion (TTC) is widely used in emergency departments and daily clinical practice. TTC may cause skin lesions on the application of apical and sternal paddle areas. The lesions are characterised by redness, erythema and blister(s), and can be defined as first degree burns locally causing pain and increased sensitivity. Aim To evaluate the effectiveness of local cold application on reducing the incidence, severity and pain/sensitivity of skin burns in patients who underwent TTC. Methods The study was conducted in the intensive care unit of the cardiovascular surgery department. The patients were assigned to study (n=24) and control groups (n=24). Local cold application was performed for a 1 hour period on patients in the study group, whereas only clinical procedures were applied in the control group following TTC. Incidence and severity of burn was evaluated 2 h after TTC, and pain/sensitivity scores were evaluated at 2, 4 and 24 h after TTC. Results The incidence of burn was significantly lower in the study group (3/24) compared to the control group (21/24) (12.5% vs 83.3%, p<0.001). Pain/sensitivity scores were significantly lower in the study group compared to the control group (p<0.05). Conclusion Local cold application following TTC is an effective means of reducing the incidence and severity of burns and pain/sensitivity. It is cost-effective and can easily be applied by nurses in medical/surgical units and emergency departments.

Communication needs of cardiac surgery patients during their wake up process

Methods This was a descriptive and observational study implemented in a training and research hospital between 1 March and 1 August, 2014, among 132 volunteering patients. The descriptive data of patients were obtained from patient records and the patients themselves. The preferred communication method and topics of intubated patients were decided after the observations taken place during their wake up process. Beginning after two hours after their wake up, the patients who were capable to speak were questioned face to face interview about the sufficiency of the communication during the wake up process.

Kardiyak Cerrahi Yoğun Bakımda Uygulanan İnvaziv ve Noninvaziv Girişimler ve Postoperatif Ağrı

Amac: Kardiyak cerrahi geciren hastalara yogun bakim unitesinde uygulanan noninvaziv-invaziv girisimlerin hastalarin agri ve bazi hemodinamik degerleri uzerine olan etkisinin belirlenmesidir.Gerec ve Yontem: Bu calisma ileriye donuk, on-son olcumlu klinik bir arastirmadir. Invaziv ve non invaziv girisimler oksuruk, solunum egzersizleri, dren sagilmasi, mobilizasyon, dren cekilmesi ve endotrakeal aspirasyon olarak belirlendi. Girisimlerden hemen once ve sonra agri algisini belirlemede Sayisal Derecelendirme Olcegi kullanildi. Ayrica kan basinci ve kalp hizi (nabiz) da girisimler oncesi ve sonrasi kaydedildi. Calismaya 62 hasta dâhil edildi. Istatistiksel analiz icin Wilcoxon Signed Rank test kullanilmis ve p<0.05 degeri istatistiksel olarak anlamli kabul edildi. Bulgular: Hastalarin yas ortalamasi 51.25±18.05 yil, cogunlugu (% 87.1) erkek olup, % 74.2’sine koroner arter-baypas greftleme cerrahisi uygulanmistir. Tum invaziv ve non invaziv girisimlerden sonra hastalarin agri puanlari istatistiksel olarak anlamli seviyede artmistir (p<0.05). En yuksek agri puani endotrakeal aspirasyon oncesi ve sonrasi kaydedilmistir (sirasiyla 7.30±1.04 ve 8.80±1.25). Dren cekilmesi ve endotrakeal aspirasyon girisimleri sonrasi hastalarin sistolik ve diyastolik kan basinclari ve nabiz degerleri istatistiksel olarak anlamli seviyede artmistir (p<0.05). Oksuruk egzersizi, dren sagilmasi ve mobilizasyon girisimleri oncesi-sonrasi nabiz, mobilizasyon oncesi-sonrasi sistolik arteriyel kan basinci degerleri arasindaki degisiklikler istatistiksel olarak anlamli bulunmustur (p<0.05). Sonuc: Tum invaziv ve noninvaziv girisimler hastalarin agri ve hemodinamik degerlerini artirmistir. Bu girisimlere yonelik hastalarin bireysel agri degerlendirmelerinin yapilarak uygun agri tedavisinin yapilmasina gereksinim oldugu dusuncesine varilmistir.