Nurse Nacole ◂ Nursing Resources

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 31 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
Low skeletal muscle area is a risk factor for mortality in ventilated patients. Muscle mass is a primary predictor of mortality, whereas BMI is not. Preserving lean body mass is a primary target of nutritional therapy in critically ill patients.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 30 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In critically ill patients, nutritional support typically aims to reduce energy and protein deficits without inducing overfeeding, providing sufficient micronutrient intake and preserving gut integrity.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 29 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In critically ill patients, inflammatory and endocrine stress responses induce variations in resting energy expenditure and urinary nitrogen excretion. Nutritional intake may be insufficient and lead to accumulated energy and protein deficits.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 28 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In ECMO, weaning depends on the mode. For VA patients, the ECMO blood flow is reduced either over a predetermined time frame set by the clinical team or fairly rapidly with echocardiographic guidance at the bedside.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 27 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In ECMO, weaning depends on the mode. For VV mode, the extracorporeal gas flow should be reduced stepwise and then gas flow clamped off from the membrane lung with monitoring of the patient’s arterial oxygenation and carbon dioxide levels.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 26 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
Severe acute respiratory distress syndrome (ARDS) continues to have a high associated mortality rate, in spite of the use of lung protective strategies that include ventilation with relatively low tidal volumes and pressures.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 25 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
ECMO can be a rescue therapy for hypoxic respiratory failure, hypercarbia despite plateau pressures >30 cm H2O, severe air leak syndrome, need for intubation for a patient on a lung transplant list or immediate cardiac or respiratory collapse.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 24 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In ECMO, air embolus in centrifugal pumps can occur and centers transitioning from roller-head to centrifugal systems often see a rise in events, as the “suction” provided by the centrifugal pump can rapidly pull air from any open stopcock.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 23 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In ECMO, pseudoaneurysms present with a pulsatile, palpable bulge and if small, generally can be managed with injection of thrombin. If large or rapidly expanding, however, these defects will usually require surgical intervention.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 22 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
Access of the femoral artery for VA-ECMO can lead to lower extremity ischemia, pseudoaneurysm formation, dissection and retroperitoneal bleeding. A distal perfusion cannula can be placed to mitigate limb ischemia.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 21 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
During ECMO, several neurologic complications, including seizures, ischemic stroke, intracranial hemorrhage and brain death may occur. The cause of neurologic injury during ECMO is complex and likely multifactorial.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 20 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
During ECMO, anticoagulation is administered during cannulation and is continued throughout the ECMO run to mitigate the risk of thrombosis in both the circuit and the patient. Unfractionated heparin remains the standard anticoagulant.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 19 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
During ECMO, a massive inflammatory response occurs because of blood contact with the ECMO circuit, upregulating the coagulation system. Both activation and consumption of platelets occur, which induce changes in the coagulation cascade.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 18 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In patients with respiratory failure on VV-ECMO, right ventricular failure can occur due to pulmonary fibrosis and increased pulmonary vascular resistance from constant exposure to the high-pressure jet returning from the ECMO circuit.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 17 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In VV ECMO, the native heart must deliver oxygenated flow to the systemic circulation. VV requires adequate cardiac function. Venous blood is diverted from the patient and reinfused into the right atrium after gas exchange.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 16 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In veno-venous ECMO, deoxygenated blood is removed from the venous system and sent via an external pump to the membrane lung where oxygen is added and carbon dioxide removed. Oxygenated blood is then returned to the venous system.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 15 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In ECMO, for patients cannulated via the femoral artery, the use of pulse oximetry or arterial blood gas data from the right hand or use of cerebral near-infrared spectroscopy may help follow oxygen saturation levels.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 14 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In harlequin” or “north-south” syndrome, methods to improve upper body oxygenation include placing another venous cannula into the right atrium, then Y’ing it into the arterial ECMO return to direct oxygenated blood to the right atrium.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 13 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In ECMO, if desaturated blood from the left heart is primarily perfusing the upper body, this results in a cyanotic upper body with a well-perfused lower body, a condition for which the terms “harlequin” or “north-south” syndrome are used.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 12 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
In ECMO patients with severe respiratory failure who are femoral artery cannulated, differential oxygen saturations of the upper and lower extremities can occur because of competing native cardiac output and returning circuit flow.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 11 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
With ECMO, oxygenated blood is usually returned to the patient via the carotid or femoral artery. The femoral artery is preferred in adolescents and adults to prevent the need to repair or sacrifice the carotid artery at the time of decannulation.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 10 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
With ECMO in venoarterial mode, deoxygenated blood is removed from the venous system and pumped to a membrane lung, which removes carbon dioxide and adds oxygen. Oxygenated blood is then returned to the patient via the arterial system.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 09 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
Extracorporeal membrane oxygenation modes are named for the sites from which the blood is drained and returned. There are two major types, venoarterial (VA) and venovenous (VV). Hybrid modes incorporate VA and VV together.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 08 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
Adverse secondary effects of targeted temperature management include shivering, electrolyte disorders, ventilatory adjustments and life-threatening hemorrhage. The subsequent rewarming phase should be slow to minimize adverse events.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 07 Oct 2026 12:00:00 +0000

Category: Critical Care Nursing
Initiation of targeted temperature management should be started as soon as possible, in particular after cardiac arrest, and maintained for a minimum period of 24 hours or longer, according to the underlying disease.