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Sepsis in the post multiple trauma patient
VOL 5 NO 2 JUNE 1992
AUSTRALIAN CRITICAL CARE
WRITING FOR PUBLICATION
Sally Robertson RN Editor, Australian Critical Care The professional development of critical care nurses highlights the need for writing and publication. Many nurses are undertaking higher degrees where research is an integral part of the program, and nurses in the workplace are steadily becoming more involved in clinical research. Non research works are also important in the body of nursing knowledge and these include articles of clinical interest, literature reviews and case studies. Scholarly discussion in the form of letters to the editor are also important avenues for debate. Therefore, when considering publication there are several issues that require addressing. The first is selecting the right target audience for the work and second, selecting the journal that targets this audience. Once this selection has been made, the preferred style, length and referencing format for the publication needs to be examined so that your submitted work complies with the standards of that journal. In most cases this information is found in the journal, or can be obtained from the editor. Presentation is the key to acceptance of the manuscript. The substance of the work must be appropriate to the specific journal, focussed on the subject, clear, logical and without excessive verbosity. The grammar and syntax must be correct and the work should demonstrate a harmonious flow of ideas. The format usually requires an abstract, introduction, main body and conclusion.
exclusively to ~~~t journals require an article to be that journal and, only if rejected, can it be submitted elsewhere. The manuscript will then undergo a refereeing process where it will be sent to two or thres experts in the field and on the basis of their comments, the editors make their decision regarding publication. It is not uncommon that manuscripts are rejected initially, however in most cases a detailed critique of the work is forwarded to the author suggesting appropriate changes. The work may then be submitted and, depending on the number of changes required, may or may not be sent for further refereeing. Once your work is accepted you are usually asked to assign copyright to that journal.
SEPSIS IN THE POST MULTIPLE TRAUMA PATIENT
Gina Robertson Intensive Care Unit Westmead Hospital Westmead, NSW With advances in pre-hospital care and transport, more severely injured patients are presenting to the Intensive Care Unit. For the patient with multiple injuries who survives the initial trauma, sepsis continues to be a significant complication, second only to severe head injury as a cause of mortality. The causes for sepsis in this patient group are multiiactorial. The patient's normal defense mechanisms of skin, gastrointestinaltract, respiratory tract, and genito urinary tract are breached or altered by either therapeutic interventions or direct trauma. Additionally, alteration and compromise in host defense mechanisms and immune responses predispose these patients to sepsis. The shock interval is a catalyst in the development of sepsis. Recently, the impaired function of the gastrointestinal tract is coming increasingly into focus as a source of pathogenic organisms following periods of hypotension. Patients with multiple trauma demand skilled and continuous nursing assessment and management, which requires a sound understanding of the pathophysiological sequelae of shock syndromes. This paper will highlight the alterations in host defense to sepsis and review nursing strategies to combat the associated risks.
AUSTRALIAN CRITICAL CARE
WRITING FOR PUBLICATION
Sally Robertson RN Editor, Australian Critical Care The professional development of critical care nurses highlights the need for writing and publication. Many nurses are undertaking higher degrees where research is an integral part of the program, and nurses in the workplace are steadily becoming more involved in clinical research. Non research works are also important in the body of nursing knowledge and these include articles of clinical interest, literature reviews and case studies. Scholarly discussion in the form of letters to the editor are also important avenues for debate. Therefore, when considering publication there are several issues that require addressing. The first is selecting the right target audience for the work and second, selecting the journal that targets this audience. Once this selection has been made, the preferred style, length and referencing format for the publication needs to be examined so that your submitted work complies with the standards of that journal. In most cases this information is found in the journal, or can be obtained from the editor. Presentation is the key to acceptance of the manuscript. The substance of the work must be appropriate to the specific journal, focussed on the subject, clear, logical and without excessive verbosity. The grammar and syntax must be correct and the work should demonstrate a harmonious flow of ideas. The format usually requires an abstract, introduction, main body and conclusion.
exclusively to ~~~t journals require an article to be that journal and, only if rejected, can it be submitted elsewhere. The manuscript will then undergo a refereeing process where it will be sent to two or thres experts in the field and on the basis of their comments, the editors make their decision regarding publication. It is not uncommon that manuscripts are rejected initially, however in most cases a detailed critique of the work is forwarded to the author suggesting appropriate changes. The work may then be submitted and, depending on the number of changes required, may or may not be sent for further refereeing. Once your work is accepted you are usually asked to assign copyright to that journal.
SEPSIS IN THE POST MULTIPLE TRAUMA PATIENT
Gina Robertson Intensive Care Unit Westmead Hospital Westmead, NSW With advances in pre-hospital care and transport, more severely injured patients are presenting to the Intensive Care Unit. For the patient with multiple injuries who survives the initial trauma, sepsis continues to be a significant complication, second only to severe head injury as a cause of mortality. The causes for sepsis in this patient group are multiiactorial. The patient's normal defense mechanisms of skin, gastrointestinaltract, respiratory tract, and genito urinary tract are breached or altered by either therapeutic interventions or direct trauma. Additionally, alteration and compromise in host defense mechanisms and immune responses predispose these patients to sepsis. The shock interval is a catalyst in the development of sepsis. Recently, the impaired function of the gastrointestinal tract is coming increasingly into focus as a source of pathogenic organisms following periods of hypotension. Patients with multiple trauma demand skilled and continuous nursing assessment and management, which requires a sound understanding of the pathophysiological sequelae of shock syndromes. This paper will highlight the alterations in host defense to sepsis and review nursing strategies to combat the associated risks.