Severe status asthmaticus
... ventilator (Ohmeda 7000, Datex-Ohmeda). Isoflurane was initially administered at an inspired concentration of 5% and then titrated down to 1% to 2% because of systolic blood pressures ⬍90 mm Hg. While on isoflurane therapy, peak airway pressure decreased from 85 to 62 cm H2O within 1 hr and fell fur ...
... ventilator (Ohmeda 7000, Datex-Ohmeda). Isoflurane was initially administered at an inspired concentration of 5% and then titrated down to 1% to 2% because of systolic blood pressures ⬍90 mm Hg. While on isoflurane therapy, peak airway pressure decreased from 85 to 62 cm H2O within 1 hr and fell fur ...
Initial and Ongoing Verification of Feeding Tube Placement in Adults
... 1. Although widely used in practice, no evidence indicates that the auscultatory method is useful for determining tube location. 2. Some evidence does indicate that the auscultatory method is not useful for distinguishing between respiratory and gastrointestinal placement of a feeding tube or for di ...
... 1. Although widely used in practice, no evidence indicates that the auscultatory method is useful for determining tube location. 2. Some evidence does indicate that the auscultatory method is not useful for distinguishing between respiratory and gastrointestinal placement of a feeding tube or for di ...
structure and function of respiratory tract in relation to
... Lie in airway smooth muscles Stimulated by distension of lung Reflex action inhibits inspiratory activity & causes bronchodilatation Determine rate & depth of breathing Insensitive to "pathological" changes in the lungs such as ...
... Lie in airway smooth muscles Stimulated by distension of lung Reflex action inhibits inspiratory activity & causes bronchodilatation Determine rate & depth of breathing Insensitive to "pathological" changes in the lungs such as ...
validation of pulmonary score in the evaluation of acute
... severity and the response to treatment. No scoring system is perfect, but some method of assessing severity in children is needed when spirometry testing is not obtainable. The PS appears to be an objective and simple scoring system for the assessment of airway obstruction for children. The PS has b ...
... severity and the response to treatment. No scoring system is perfect, but some method of assessing severity in children is needed when spirometry testing is not obtainable. The PS appears to be an objective and simple scoring system for the assessment of airway obstruction for children. The PS has b ...
Preventing Aspiration in Older Adults with Dysphagia
... BEST PRACTICES: ASSESSMENT AND PREVENTION ASSESSMENT Videofluoroscopy is considered the gold standard to study the mechanisms of dysphagia; if unavailable, fiberoptic endoscopic evaluation may be used instead (Rofes et al., 2011). Others recommend these tests only for patients who fail a reliable cl ...
... BEST PRACTICES: ASSESSMENT AND PREVENTION ASSESSMENT Videofluoroscopy is considered the gold standard to study the mechanisms of dysphagia; if unavailable, fiberoptic endoscopic evaluation may be used instead (Rofes et al., 2011). Others recommend these tests only for patients who fail a reliable cl ...
Assisted Ventilation of the Neonate
... • One of the initial forms of respiratory support used in preterm infants with RDS • Recently it has been reintroduced for initial management of RDS and indications such as apnea and to improve extubation success after invasive ventilation ...
... • One of the initial forms of respiratory support used in preterm infants with RDS • Recently it has been reintroduced for initial management of RDS and indications such as apnea and to improve extubation success after invasive ventilation ...
Same role and same treatment for airway eosinophilia EDITORIAL
... dissimilar. These findings provide a rationale for a treatment strategy based on sputum eosinophil count. Other longer prospective studies, including cost/benefit evaluation, are needed before the utility of this strategy in clinical practice can be established. ...
... dissimilar. These findings provide a rationale for a treatment strategy based on sputum eosinophil count. Other longer prospective studies, including cost/benefit evaluation, are needed before the utility of this strategy in clinical practice can be established. ...
File - Respiratory Therapy Files
... • Auto-PEEP causes dynamic hyperinflation – leads to difficulty triggering ventilator & increased work of breathing • Causes hypertension and reduced cardiac output • Suspected when flow does not return to baseline in flow-time curve. • Treatment: reduce TI, VE and correct RAW ...
... • Auto-PEEP causes dynamic hyperinflation – leads to difficulty triggering ventilator & increased work of breathing • Causes hypertension and reduced cardiac output • Suspected when flow does not return to baseline in flow-time curve. • Treatment: reduce TI, VE and correct RAW ...
Breathe In, Breathe Out: Redesigning Inhalers for Asthma Patients
... chronic obstructive pulmonary disease were mostly delivered via nebulizers. However, after the development of bronchodilator drugs in pressurized containers, there was a gradual shift in preference. The pressurized metered-dose inhaler (pMDI) became the most important device in delivering inhaled dr ...
... chronic obstructive pulmonary disease were mostly delivered via nebulizers. However, after the development of bronchodilator drugs in pressurized containers, there was a gradual shift in preference. The pressurized metered-dose inhaler (pMDI) became the most important device in delivering inhaled dr ...
Chapter 21 - Revsworld
... breathing or who exhibit signs of respiratory distress – Those with absent or inadequate breathing and who require continuous positivepressure ventilation ...
... breathing or who exhibit signs of respiratory distress – Those with absent or inadequate breathing and who require continuous positivepressure ventilation ...
Asthma/Chronic Obstructive Pulmonary Disease
... While IS is the most studied and widely implemented of the noninvasive techniques, it does have its drawbacks. It is to some extent invasive, albeit much less so than BAL. IS has proved difficult to perform in children and very ill patients, as the act of expectorating sputum can be stressful for th ...
... While IS is the most studied and widely implemented of the noninvasive techniques, it does have its drawbacks. It is to some extent invasive, albeit much less so than BAL. IS has proved difficult to perform in children and very ill patients, as the act of expectorating sputum can be stressful for th ...
guidelines for emergency tracheal intubation
... Studies describing patients managed by ground EMS crews and a receiving trauma center staff indicate that the rate of tracheal intubation is 13.6%, but varies from 11 to 30%.19,22,67,82 It is clear that trauma patients with acute respiratory system insufficiency commonly have critical injuries, may ...
... Studies describing patients managed by ground EMS crews and a receiving trauma center staff indicate that the rate of tracheal intubation is 13.6%, but varies from 11 to 30%.19,22,67,82 It is clear that trauma patients with acute respiratory system insufficiency commonly have critical injuries, may ...
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA
... Respiratory failure in neonates, defined as retention of carbon dioxide with a resultant decrease in the arterial blood pH and accompanied by hypoxemia, has multiple etiologies. Respiratory failure is a result of impaired pulmonary gas exchange mechanisms, such as can be seen with surfactant deficie ...
... Respiratory failure in neonates, defined as retention of carbon dioxide with a resultant decrease in the arterial blood pH and accompanied by hypoxemia, has multiple etiologies. Respiratory failure is a result of impaired pulmonary gas exchange mechanisms, such as can be seen with surfactant deficie ...
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
... repeat up to every 15-30 minutes if required continuous nebulization of salbutamol 10mg/h if inadequate response to initial treatment ...
... repeat up to every 15-30 minutes if required continuous nebulization of salbutamol 10mg/h if inadequate response to initial treatment ...
Chapter 42: Neonatal Care - Jones & Bartlett Learning
... • Advance until air is recovered. • Remove when there is no more air to withdraw. ...
... • Advance until air is recovered. • Remove when there is no more air to withdraw. ...
ventilation - ALS Society of Canada
... those with spinal cord injuries, is being Disadvantages o Gastric distention may occur which is uncomfortable tested to see if it is an effective method o Most centres are familiar with o Coughing to clear the for breathing support and better surtraditional invasive ventilation airways is difficult ...
... those with spinal cord injuries, is being Disadvantages o Gastric distention may occur which is uncomfortable tested to see if it is an effective method o Most centres are familiar with o Coughing to clear the for breathing support and better surtraditional invasive ventilation airways is difficult ...
Soft palate muscle responses to negative upper airway pressure
... (VT ) was measured by electrical integration of the flow signal. In six dogs (group 1), pressure in the laryngeal lumen was measured with a pressure transducer attached to a side port on the cranial tracheal cannula. With the use of three-way taps, a high-impedance negative-pressure source was conne ...
... (VT ) was measured by electrical integration of the flow signal. In six dogs (group 1), pressure in the laryngeal lumen was measured with a pressure transducer attached to a side port on the cranial tracheal cannula. With the use of three-way taps, a high-impedance negative-pressure source was conne ...
Burns and Thermal Injuries
... These are used as guidelines for the initial fluid management after burn. The response to fluid resuscitation should be continuously monitored, and adjustments in the rate of fluid administration should be made accordingly. ...
... These are used as guidelines for the initial fluid management after burn. The response to fluid resuscitation should be continuously monitored, and adjustments in the rate of fluid administration should be made accordingly. ...
Bronchiectasis associated with inflammatory bowel disease
... essentials of a unique disease, subsequently identified in many patients in several studies. The authors reported the occurrence of aggressive ulcerous bronchitis and bronchiectasis (confirmed on contrast bronchography), associated with profuse bronchorrhoea and haempotysis, in a 38year-old female 1 ...
... essentials of a unique disease, subsequently identified in many patients in several studies. The authors reported the occurrence of aggressive ulcerous bronchitis and bronchiectasis (confirmed on contrast bronchography), associated with profuse bronchorrhoea and haempotysis, in a 38year-old female 1 ...
Adult Nasal and Oropharyngeal Suction
... Nasotracheal and orotracheal suction should only be undertaken when other less invasive techniques have proved unsuccessful, and where the secretions are causing physiological deterioration and / or distress (Pedersen et al., 2008) Indications that the patients may need suctioning include audible se ...
... Nasotracheal and orotracheal suction should only be undertaken when other less invasive techniques have proved unsuccessful, and where the secretions are causing physiological deterioration and / or distress (Pedersen et al., 2008) Indications that the patients may need suctioning include audible se ...
Tracheostomy Tubes and Related Appliances
... manufacturers, are not commonly appreciated but may have important clinical implications. Tracheostomy tubes can be angled or curved, a feature that can be used to improve the fit of the tube in the trachea. Extra proximal length tubes facilitate placement in patients with large necks, and extra dis ...
... manufacturers, are not commonly appreciated but may have important clinical implications. Tracheostomy tubes can be angled or curved, a feature that can be used to improve the fit of the tube in the trachea. Extra proximal length tubes facilitate placement in patients with large necks, and extra dis ...
TEXT
... Feeding evolves from reflexive suckling in infancy to voluntary swallowing in adulthood. In utero, swallowing begins at 16 weeks gestation, and plays an important role in maintenance of amniotic fluid balance. Suckling begins in the 2nd and 3rd trimesters. In premature infants, suckling is poorly co ...
... Feeding evolves from reflexive suckling in infancy to voluntary swallowing in adulthood. In utero, swallowing begins at 16 weeks gestation, and plays an important role in maintenance of amniotic fluid balance. Suckling begins in the 2nd and 3rd trimesters. In premature infants, suckling is poorly co ...
Viral and Bacterial Pneumonia in the Pediatric Patient
... Diagnosis confirmed by >15-20% fall in PEFR or FEV1 after – formal exercise challenge test taking into account the type of exercise, temperature and relative humidity (confirmed by a positive test, but not excluded by a negative test); – formal eucapnic hyperventilation challenge as an alternative ( ...
... Diagnosis confirmed by >15-20% fall in PEFR or FEV1 after – formal exercise challenge test taking into account the type of exercise, temperature and relative humidity (confirmed by a positive test, but not excluded by a negative test); – formal eucapnic hyperventilation challenge as an alternative ( ...
AARC Clinical Practice Guideline
... 6.6 Caregiver exposure to droplet nuclei of My cobacterium tuberculosis or other airborne contagious microorganism produced as a consequence of coughing, particularly during sputum induction 6.7 Edema of the airway wall13 6.8 Edema associated with decreased compliance and gas exchange and with incre ...
... 6.6 Caregiver exposure to droplet nuclei of My cobacterium tuberculosis or other airborne contagious microorganism produced as a consequence of coughing, particularly during sputum induction 6.7 Edema of the airway wall13 6.8 Edema associated with decreased compliance and gas exchange and with incre ...
Slide 1
... F/U CXR may be ordered to assess re-expansion of lung and resolution of pneumothorax. Important: re-expansion pulmonary edema may occur with rapid lung re-expansion s/p tube thoracostomy. This is a potential life threatening situation which can lead to cardiovascular collapse. Keep chest tube on ...
... F/U CXR may be ordered to assess re-expansion of lung and resolution of pneumothorax. Important: re-expansion pulmonary edema may occur with rapid lung re-expansion s/p tube thoracostomy. This is a potential life threatening situation which can lead to cardiovascular collapse. Keep chest tube on ...
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.