manual of critical care nursing practice
... Maneuver by which pressure during mechanical ventilation is maintained above atmospheric at end of exhalation, resulting in an increased functional residual capacity. Airway pressure is therefore positive throughout the entire ventilatory cycle. Purpose is to increase functional residual capacit ...
... Maneuver by which pressure during mechanical ventilation is maintained above atmospheric at end of exhalation, resulting in an increased functional residual capacity. Airway pressure is therefore positive throughout the entire ventilatory cycle. Purpose is to increase functional residual capacit ...
Mechanical Ventilator What is it?
... patient’s own inspiratory effort but will initiate the breath if the patient does not do so within the set amount of time. -This means that any inspiratory attempt by the patient triggers a ventilator breath. -The patient may need to be sedated to limit the number of spontaneous breaths since hyperv ...
... patient’s own inspiratory effort but will initiate the breath if the patient does not do so within the set amount of time. -This means that any inspiratory attempt by the patient triggers a ventilator breath. -The patient may need to be sedated to limit the number of spontaneous breaths since hyperv ...
Comparing the effect of using normal saline, N
... it can be pointed out to aspiration system infection which is the most common hospital infection, cyanosis and dizziness, accumulation of air in the pleural, increased intracranial pressure and decreased tissue oxygen [4, 11]. If the patient’s secretions are thick, stick and bulky and are not remove ...
... it can be pointed out to aspiration system infection which is the most common hospital infection, cyanosis and dizziness, accumulation of air in the pleural, increased intracranial pressure and decreased tissue oxygen [4, 11]. If the patient’s secretions are thick, stick and bulky and are not remove ...
Resuscitation CPG - Respiratory Care
... sizes for adults. They consist of a soft rubber or plastic tube with a beveled tip and a flange that preferably is adjustable. 10.2.3.3 Endotracheal tubes should be available in a variety of sizes for adults. Tubes should meet ASTM standards.136 10.2.3.4 Intubation devices facilitate intubation and ...
... sizes for adults. They consist of a soft rubber or plastic tube with a beveled tip and a flange that preferably is adjustable. 10.2.3.3 Endotracheal tubes should be available in a variety of sizes for adults. Tubes should meet ASTM standards.136 10.2.3.4 Intubation devices facilitate intubation and ...
The Oxygen Goes In…
... retain more CO2 while receiving O2 Therapy during an exacerbation? Yes. This situation unnecessarily alarms the healthcare team. This phenomenon is believed to be a result of the effect of oxygen therapy on HPVC, and the resultant increase in dead-space ventilation that occurs. Treatment of ...
... retain more CO2 while receiving O2 Therapy during an exacerbation? Yes. This situation unnecessarily alarms the healthcare team. This phenomenon is believed to be a result of the effect of oxygen therapy on HPVC, and the resultant increase in dead-space ventilation that occurs. Treatment of ...
Pathophysiology of Respiratory Failure and Indications for
... a whole, leading to a decrease in conscious level, an inability to protect the airways and the risk of respiratory obstruction and pulmonary aspiration. Abnormalities of the spinal cord – injury to the spinal cord will affect the innervation of the diaphragm and thoracic intercostal muscles and caus ...
... a whole, leading to a decrease in conscious level, an inability to protect the airways and the risk of respiratory obstruction and pulmonary aspiration. Abnormalities of the spinal cord – injury to the spinal cord will affect the innervation of the diaphragm and thoracic intercostal muscles and caus ...
Auto-positive end-expiratory pressure
... radial traction are lost. Consequently, during exhalation, when the pleural pressure is positive, these airways can be compressed and collapse. The flow of air during expiration is therefore limited and cannot be augmented by effort, resulting in auto-PEEP and dynamic hyperinflation.12 This conditio ...
... radial traction are lost. Consequently, during exhalation, when the pleural pressure is positive, these airways can be compressed and collapse. The flow of air during expiration is therefore limited and cannot be augmented by effort, resulting in auto-PEEP and dynamic hyperinflation.12 This conditio ...
Breathing Basics and Care Choices for SMA Type II and III
... BREATHING SUPPORT (Interfaces) • Non-invasive Ventilation ...
... BREATHING SUPPORT (Interfaces) • Non-invasive Ventilation ...
IAD: Cough, Poor Performance, Mucus in the Airways--What Is
... The most common clinical signs associated with IAD are increased respiratory secretions, cough, and decreased performance.8,19,30 Estimation of the quantity of mucus present in the trachea by endoscopy reveals that horses free of respiratory disease have either no mucus or a few isolated flecks and ...
... The most common clinical signs associated with IAD are increased respiratory secretions, cough, and decreased performance.8,19,30 Estimation of the quantity of mucus present in the trachea by endoscopy reveals that horses free of respiratory disease have either no mucus or a few isolated flecks and ...
Document
... • In the healthy lung the radius is relatively large and so R is low • The airways normally offer such a low resistance that only small pressure gradients are needed for adequate airflow into the lung ...
... • In the healthy lung the radius is relatively large and so R is low • The airways normally offer such a low resistance that only small pressure gradients are needed for adequate airflow into the lung ...
Respiratory Mechanics
... (with some reduction due to airflow resistance) as a positive alveolar gas pressure. By intermittently restoring atmospheric pressure at the airway entrance, lung recoil produces passive expiration. Another point: following thoracic surgery, air normally remains in the pleural cavity; this is expell ...
... (with some reduction due to airflow resistance) as a positive alveolar gas pressure. By intermittently restoring atmospheric pressure at the airway entrance, lung recoil produces passive expiration. Another point: following thoracic surgery, air normally remains in the pleural cavity; this is expell ...
an ipv® operational manual - Refurbished medical equipment and
... recruited during the positive pressure inspiratory phase. 6. Coughlator type devices designed to produce an artificial cough in patients with Polio (who essentially had normal lungs) generally only serve to help clear the upper airway of normal, less viscid secretions. 7. Chest physiotherapy, while ...
... recruited during the positive pressure inspiratory phase. 6. Coughlator type devices designed to produce an artificial cough in patients with Polio (who essentially had normal lungs) generally only serve to help clear the upper airway of normal, less viscid secretions. 7. Chest physiotherapy, while ...
PALS
... (as appropriate) to limit resuscitative efforts or to withhold attempts at resuscitation, a physician order indicating the limits of resuscitative efforts must be written for use in the in-hospital setting, and in most countries a separate order must be written for the out-of-hospital setting. Legal ...
... (as appropriate) to limit resuscitative efforts or to withhold attempts at resuscitation, a physician order indicating the limits of resuscitative efforts must be written for use in the in-hospital setting, and in most countries a separate order must be written for the out-of-hospital setting. Legal ...
respiratiory eximination
... through expiration, fading about one third of the way through expiration. It is typically rustling due to the passage through alveoli which selectively transmit sounds of lower frequency and dampen the higher frequency sounds. It is normally heard over the chest. BRONCHIAL: These sounds are louder a ...
... through expiration, fading about one third of the way through expiration. It is typically rustling due to the passage through alveoli which selectively transmit sounds of lower frequency and dampen the higher frequency sounds. It is normally heard over the chest. BRONCHIAL: These sounds are louder a ...
a new patient management paradigm
... insufficiency/failure, whereas the latter may be ventilatory insufficiency/failure. Unfortunately, many physicians rarely distinguish between the two, referring to both, as well as evaluating and treating both, as respiratory insufficiency/ failure. This results in needless morbidity and mortality, ...
... insufficiency/failure, whereas the latter may be ventilatory insufficiency/failure. Unfortunately, many physicians rarely distinguish between the two, referring to both, as well as evaluating and treating both, as respiratory insufficiency/ failure. This results in needless morbidity and mortality, ...
Ventilator-Associated Pneumonia (VAP)
... Symptoms of fever (>38.3C), leukocytosis (> 10,000), leukopenia (<5,000), purulent secretions and new or changing infiltrates seen on chest films, when considered separately, do not make the diagnosis of VAP, as the densities may be explained by other causes. However, most clinicians upon observing ...
... Symptoms of fever (>38.3C), leukocytosis (> 10,000), leukopenia (<5,000), purulent secretions and new or changing infiltrates seen on chest films, when considered separately, do not make the diagnosis of VAP, as the densities may be explained by other causes. However, most clinicians upon observing ...
Respiratory Acidosis
... difference between the 'actual' pCO2 and the 'expected' pCO2 - actual pCO2 = the measured value obtained from arterial blood gas analysis. - expected pCO2 = the value of pCO2 that we calculate would be present taking into account the presence of any metabolic acid-base disorder Expected pCO2 = 1.5 ( ...
... difference between the 'actual' pCO2 and the 'expected' pCO2 - actual pCO2 = the measured value obtained from arterial blood gas analysis. - expected pCO2 = the value of pCO2 that we calculate would be present taking into account the presence of any metabolic acid-base disorder Expected pCO2 = 1.5 ( ...
Abdominal Compression Increases Upper Airway Collapsibility
... but the mechanisms via which these factors contribute to OSA remain unclear. Central obesity, particularly common in obese male OSA patients, leads to increased intra-abdominal pressure (IAP). This pressure may have an important influence on diaphragm position, which may affect the degree of axial t ...
... but the mechanisms via which these factors contribute to OSA remain unclear. Central obesity, particularly common in obese male OSA patients, leads to increased intra-abdominal pressure (IAP). This pressure may have an important influence on diaphragm position, which may affect the degree of axial t ...
Preventing Aspiration - Clinical Journal of Oncology Nursing
... and ingested materials (e.g., food, medications, oropharyngeal bacteria, other infectious agents) can be aspirated. Aspiration occurs in as many as 45% of healthy individuals, but the aspirate is cleared from the pulmonary tree by intact cough and gag reflexes and does not result in aspiration syndr ...
... and ingested materials (e.g., food, medications, oropharyngeal bacteria, other infectious agents) can be aspirated. Aspiration occurs in as many as 45% of healthy individuals, but the aspirate is cleared from the pulmonary tree by intact cough and gag reflexes and does not result in aspiration syndr ...
Pediatric Airway Maintenance and Clearance in the
... with a cupped hand, pneumatic or electro-mechanical percussor, or a round sealed applicator. Clinicians should not percuss over bony prominences, the spine, sternum, abdomen, last few ribs, sutured areas, drainage tubes, kidneys, liver, or below the rib cage. The ideal frequency of percussion is unk ...
... with a cupped hand, pneumatic or electro-mechanical percussor, or a round sealed applicator. Clinicians should not percuss over bony prominences, the spine, sternum, abdomen, last few ribs, sutured areas, drainage tubes, kidneys, liver, or below the rib cage. The ideal frequency of percussion is unk ...
Document
... If vascular access is available, epinephrine should be given intravenously at a dose of 0.01– 0.02 mg/kg. Epinephrine is supplied as 1 mg/ml; therefore, the dose for a typical 50-kg foal is 0.5–1.0 ml. Epinephrine has a short half-life; therefore, if there is no response after the first dose, additio ...
... If vascular access is available, epinephrine should be given intravenously at a dose of 0.01– 0.02 mg/kg. Epinephrine is supplied as 1 mg/ml; therefore, the dose for a typical 50-kg foal is 0.5–1.0 ml. Epinephrine has a short half-life; therefore, if there is no response after the first dose, additio ...
BLS Guideline 2 – Ventilation
... tracheostomy rather than laryngectomy thus allowing air to escape from the mouth and nose. In this case the hand may need to be placed over the mouth and nose to help seal it. If the stoma or tube is blocked use back blows and abdominal thrusts in an attempt to dislodge the obstruction (see Guidelin ...
... tracheostomy rather than laryngectomy thus allowing air to escape from the mouth and nose. In this case the hand may need to be placed over the mouth and nose to help seal it. If the stoma or tube is blocked use back blows and abdominal thrusts in an attempt to dislodge the obstruction (see Guidelin ...
Anesthetic Management of Costello Syndrome
... system anomalies characterize this syndrome.3 At times, in infants and young children it may be difficult to distinguish Costello syndrome from cardiofaciocutaneous syndrome or Noonan syndrome.1 Costello syndrome was first identified in New Zealand when a pediatrician noticed a striking similarity i ...
... system anomalies characterize this syndrome.3 At times, in infants and young children it may be difficult to distinguish Costello syndrome from cardiofaciocutaneous syndrome or Noonan syndrome.1 Costello syndrome was first identified in New Zealand when a pediatrician noticed a striking similarity i ...
Paediatric Resuscitation Guidelines 2010 - Vula
... • Age > 8 years • use adult AED • Age 1-8 years • use paediatric pads / settings if available (otherwise use adult ...
... • Age > 8 years • use adult AED • Age 1-8 years • use paediatric pads / settings if available (otherwise use adult ...
Tracheal intubation
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction.The most widely used route is orotracheal, in which an endotracheal tube is passed through the mouth and vocal apparatus into the trachea. In a nasotracheal procedure, an endotracheal tube is passed through the nose and vocal apparatus into the trachea. Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated.Because it is an invasive and extremely uncomfortable medical procedure, intubation is usually performed after administration of general anesthesia and a neuromuscular-blocking drug. It can however be performed in the awake patient with local or topical anesthesia, or in an emergency without any anesthesia at all. Intubation is normally facilitated by using a conventional laryngoscope, flexible fiberoptic bronchoscope or video laryngoscope to identify the vocal cords and pass the tube between them into the trachea instead of into the esophagus. Other devices and techniques may be used alternatively.After the trachea has been intubated, a balloon cuff is typically inflated just above the far end of the tube to help secure it in place, to prevent leakage of respiratory gases, and to protect the tracheobronchial tree from receiving undesirable material such as stomach acid. The tube is then secured to the face or neck and connected to a T-piece, anesthesia breathing circuit, bag valve mask device, or a mechanical ventilator.Once there is no longer a need for ventilatory assistance and/or protection of the airway, the tracheal tube is removed; this is referred to as extubation of the trachea (or decannulation, in the case of a surgical airway such as a cricothyrotomy or a tracheotomy).For centuries, tracheotomy was considered the only reliable method for intubation of the trachea. However, because only a minority of patients survived the operation, physicians undertook tracheotomy only as a last resort, on patients who were nearly dead. It was not until the late 19th century however that advances in understanding of anatomy and physiology, as well an appreciation of the germ theory of disease, had improved the outcome of this operation to the point that it could be considered an acceptable treatment option.Also at that time, advances in endoscopic instrumentation had improved to such a degree that direct laryngoscopy had become a viable means to secure the airway by the non-surgical orotracheal route. By the mid-20th century, the tracheotomy as well as endoscopy and non-surgical tracheal intubation had evolved from rarely employed procedures to becoming essential components of the practices of anesthesiology, critical care medicine, emergency medicine, laryngology.Tracheal intubation can be associated with minor complications such as broken teeth or lacerations of the tissues of the upper airway. It can also be associated with potentially fatal complications such as pulmonary aspiration of stomach contents which can result in a severe and sometimes fatal chemical aspiration pneumonitis, or unrecognized intubation of the esophagus which can lead to potentially fatal anoxia. Because of this, the potential for difficulty or complications due to the presence of unusual airway anatomy or other uncontrolled variables is carefully evaluated before undertaking tracheal intubation. Alternative strategies for securing the airway must always be readily available.