The NDE is a fascinating but not uncommon phenomenon that some trauma victims experience during physical crises or periods of apparent clinical death. When critical care trauma nurses are familiar with the characteristics of the experience, they are able to assist trauma victims to understand available information about NDEs. More important, critical care nurses are able to assist victims and their families to understand the meanings of the NDE and how it affects their lives.
The link between traumatic injury and alcohol consumption is strong. Although statistics vary, from one half to one third of trauma victims admitted to critical care units have an alcohol-related injury. The initial role of the critical care nurse is to identify the presence of alcohol by monitoring the patient's BAC. Once the presence of alcohol is confirmed, its effects impact directly on the plan of care that evolves during the critical illness. Nursing interventions focus on four specific areas affected by alcohol: the ability of alcohol to mask injury, the effects of alcohol on medications, alcohol withdrawal, and rehabilitation from alcoholism. By incorporating these four areas into the plan of care, the critical care nurse assists the patient not only to recover from a traumatic injury but also to deal with a problem drinking pattern.
The initial minutes and hours of nursing care of the trauma victim make a critical difference in the patient's chance for recovery. The critical care and ED nurse's ability to provide fluid resuscitation rapidly to augment the patient's flagging vascular volume is critical to the maintenance of circulation. By administering the most appropriate solution to meet the trauma patient's physiologic requirements, the nurse ensures that the patient will have an adequate circulating volume to meet the oxygenation and nutritional requirements of body tissues. Early, rapid fluid resuscitation is essential to stave off noncompensatory, irreversible shock. By implementing specific nursing care strategies to increase the flow of IV solutions to the patient, the nurse combats the nursing diagnosis appropriate for almost every multiple trauma victim: Fluid Volume Deficit.
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