Susan Budassi Sheehy

A nurse-coached exercise program to increase muscle strength, improve quality of life, and increase self-efficacy in people with tetraplegic spinal cord injuries.

ABSTRACTA nurse-coached exercise intervention for 10 people with tetraplegic spinal cord injuries was conducted over a period of 2 years at an accessible, community-based YMCA using an equipment especially designed for people with mobility issues and neurological deficits. In this single-subject design study, each participant completed three 3-hour exercise sessions a week for over 6 months. The purpose of the study was to determine what effects the program would have on increasing muscle strength, improving quality of life, and increasing self-efficacy after traditional outpatient therapy sessions were no longer available or affordable. The Sheehy Spinal Cord Injury Functional Improvement via Exercise Model was constructed at the conclusion of an unpublished pilot study and was tested in this study. Expectations of the model were that, if a person with a tetraplegic spinal cord injury participated in a coached program of exercise, muscle strength would increase and functional ability would improve, resulting in greater independence, a higher sense of self-efficacy, and a higher quality of life. Study results using a single-subject design of graph-trend analysis showed upward trajectories in muscle strength, quality of life, and self-efficacy in all study participants regardless of the length of time since his or her original injury. The results support the efficacy of this nurse-coached program for people with tetraplegic spinal cord injuries and validate the Sheehy Spinal Cord Injury Functional Improvement via Exercise Model.

Justifying the cost of an air medical transport (rotorcraft) program

Summary These are several ideas to help justify the cost of an air medical transport program. I am sure there are more, and I invite you to share them with our readers. Whatever justifications are made, they must be made carefully and always with patient outcomes and community satisfaction in the fore.

Infections in pregnant women: The need to assess and possibly treat the fetus and the sexual partner as well

Assessing and treating pregnant women in the emergency department for complaints unrelated to pregnancy are complex processes at best. Obtaining a consultation from an obstetrician is always prudent, even if it is simply by telephone. Careful attention to laboratory and other diagnostic test results is imperative, and communication with the patients primary care physician and/or obstetrician is a must. Assessment of fetal well-being should be documented, and implications for the fetus of all treatments and/or omitted treatments should be considered. With infections in pregnant women, remember to think about implications for the baby and the womans sexual partner; both may need to be assessed and treated.

Manual of Clinical Trauma Care: The First Hour

PART ONE Trauma Care Systems . The Model Trauma System . Hospital Systems of Care . Mass Casualty and Disaster Preparedness . PART TWO Clinical Principles . Mechanism of Injury . Prehospital Care . Patient Transfer . Shock and Fluid Replacement in Trauma . Wounds and Wound Management . Trauma Laboratory Tests . Crisis Intervention in Trauma . Critical Incident Stress Management . Nursing Diagnosis in Trauma . Organ and Tissue Donation . Injury Prevention . PART THREE Clinical Practice . Trauma Initial Assessment . Head Trauma . Spine and Spinal Cord Trauma . Facial and EENT Trauma . Chest Trauma . Abdominal, Genitourinary, and Pelvic Trauma . Extremity and Vascular Trauma . Burn Injuries . PART FOUR Special Populations . Pediatric Trauma . Trauma in Pregnancy . Trauma in the Elderly . Interpersonal Violence . PART FIVE Clinical Skills and Procedures . Skills for Trauma Management