Financial Disclosures. Goal. Overview. Pre-Oxygenation N 2 O 2. Pre-Oxygenation 3/20/2017. Optimizing Intubation. None
|
|
|
- Giles Randall
- 5 years ago
- Views:
Transcription
1 Financial Disclosures None Optimizing Intubation Rahul Bhat, M.D. FACEP Associate Program Director Associate Professor of Emergency Medicine MedStar Georgetown University Hospital MedStar Washington Hospital Center Goal Get that ET tube in on your first attempt without your patient desatting or dying Overview Maximizing Preparation Positioning Post Intubation Care Goal: O 2 crashing patient = more time for laryngoscopy Exchange alveolar nitrogen for oxygen Start high- non-rebreather mask Increase alveoli available for oxygenation N 2 O 2 Length of pre-oxygenation 3 minutes (if possible) Position Head elevated Reverse Trendelenberg Buys you sec 1
2 Flush Rate Standard 15 L/min Rotate dial to max Increased FeO 2 RCT of NIV vs NRB pre-intubation Driver, B. E., Prekker, M. E., Kornas, R. L., Cales, E. K., & Reardon, R. F. Ann Emerg Med 2017;69(1):1-6. Baillard C, et al. AJRCCM Peri-intubation mean SpO 2 100% 90% Non-Invasive Ventilation: Upside pre-oxygenation, no gastric distension Downside lose access to airway 85% 80% NIV NRB 75% 70% Baseline Before ETI During ETI ETI + 5 ETI + 30 Baillard C, et al. AJRCCM BVM Avoid If possible gastric distension No extra O 2 Use only when BiPAP/CPAP failed use PEEP valve Apneic Oxygenation Nasal cannula (requires second O 2 tree) High and tight valve= CPAP Levitan RM. No DESAT! Emergency Physicians Monthly December 9,
3 Risk Category Oxygenation strategy Preoxygenation 91- < 91% Onset of paralytic >96% Nonrebreather Nonrebreather and NC high As above or Weingart SD, Levitan RM. Ann EmergMed 2012;59(3): Apneic Period Risk Category Oxygenation strategy Preoxygenation 91- < 91% Onset of paralytic >96% Nonrebreather Nonrebreather and NC high As above or Weingart SD, Levitan RM. Ann EmergMed 2012;59(3): Apneic Period Risk Category Oxygenation strategy Preoxygenation 91- < 91% Onset of paralytic >96% Nonrebreather Nonrebreather and NC high As above or Weingart SD, Levitan RM. Ann EmergMed 2012;59(3): Apneic Period O 2 sat > Take Home Points In the non-agonal respirations patient Optimize O 2 prior to pushing drugs O 2 sat < Apneic O 2 for All Apneic/ Obtunded Suction Backup device IV with saline ing CO 2 detector Tube Preparation Tube Prep - Straight to Cuff Cadaver study bend of tube < 35 o provides optimal tube passage Levitan RM. Pisaturo JT, Kinkle WC, Butler K, Everett WW. Acad Emerg Med Dec;13(12):
4 Patient Positioning Ear to sternal notch Obese patients All patients best view Airway positioning Cricoid pressure Aka Sellick s maneuver Greenland KB, Edwards MJ, Hutton NJ, Challis VJ, Irwin MG, Sleigh JW. Br J Anaesth Nov;105(5): Cricoid Pressure End of an Era MRI studies Inferior laryngeal view Airway collapses Esophagus incompletely/not occluded > 80% attempts Boet S, Duttchen K, Chan J, Chan AW, Morrish W, Ferland A, Hare GM, Hong AP. J Emerg Med May;42(5): BURP Is there a better way? Is there a better way? RCT: Bimanual laryngoscopy/elm vs BURP vs CP Better view Easier to pass tube Levitan RM, Kinkle WC, Levin JL, et al. Ann Emerg Med. 2006;47:
5 Goal Get that ET tube in on your first attempt without your patient desatting or dying Intubation Checklist Preoxygenate (15L/min NC + NRB, BiPAP) Prepare (Suction, Backup, Code Crit Airway?) Peripheral IV (with IVF ing) Plan vent settings (estimate MV; IBW) Position (Ear to sternal notch) Premedicate (Etomidate 0.3 mg/kg) Paralyze (Sux 1.5 mg/kg; Roc 1 mg/kg IBW if K) Placement check (Graphic EtCO 2 ) Tube s In! Patient s alive! Post Intubation Care ABG OGT placement CXR Sedation Vent settings Continuous ETCO 2 (non c-spine precautions) Head of bed > 30 o Post Intubation Care Post-Intubation Checklist Ventilator: TV 6cc/kg IBW Match pre-intubation min. vent. Titrate FiO 2 < 60% (Goal SpO %) Sedative (consider adding opiate) OGT pre-cxr Bhat, R., Goyal, M., Graf, S., et al Western JEM, 2014; 15(6): 708. Head of Bed 30 (except ischemic CVA) ABG within 30 minutes Consider restraints 5
6 Take Home Points In the non-agonal respirations patient Cricoid Pressure Airway positioning Optimize O 2 prior to pushing drugs O 2 sat > O 2 sat < Apneic/ Obtunded Apneic O 2 for All Take Home Points Bimanual laryngoscopy/elm Better view Easier to pass tube Post Intubation Care ABG OGT placement CXR Sedation Vent settings Continuous ETCO 2 (non c-spine precautions) Head of bed > 30 o Levitan RM. No DESAT! Emergency Physicians Monthly December 9, Thank You! 6
It costs you nothing, but gains everything for your patient!
It costs you nothing, but gains everything for your patient! Attend the entire presentation Complete and submit the evaluation This session is approved for: ANCC hours CECBEMS hours No partial credit will
Airway management. Gabriel Blecher
Airway management Gabriel Blecher Richard Levitan 1: Weingart SD, Levitan RM. Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med. 2012 Mar;59(3):165-75.e1.
ADVANCED AIRWAY MANAGEMENT
The Advanced Airway Management protocol should be used on all patients requiring advanced airway management procedures. This protocol is divided into three sections the Crash Airway Algorithm, the Rapid
INTUBATION/RSI. PURPOSE: A. To facilitate secure, definitive control of the airway by endotracheal intubation in an expeditious and safe manner
Manual: LifeLine Patient Care Protocols Section: Adult/Pediatrics Protocol #: AP1-009 Approval Date: 03/01/2018 Effective Date: 03/05/2018 Revision Due Date: 12/01/2018 INTUBATION/RSI PURPOSE: A. To facilitate
Emergency Department/Trauma Adult Airway Management Protocol
Emergency Department/Trauma Adult Airway Management Protocol Purpose: A standardized protocol for management of the airway in the setting of trauma in an academic center, with the goal of maximizing successful
Tracheal Intubation in ICU: Life saving or life threatening?
Tracheal Intubation in ICU: Life saving or life threatening? Prof. Sheila Nainan Myatra Department of Anaesthesia, Critical Care & Pain Tata Memorial Hospital Mumbai, India sheila150@hotmail.com Three
Airway 2015 Updates in Emergency Airway Management
Airway 2015 Updates in Emergency Airway Management Gerry Maloney, DO, FACOEP Associate Medical Director, Metro Life Flight Attending Physician, Emergency Medicine, CWRU/MetroHealth Medical Center None
Rapid Sequence Induction
Rapid Sequence Induction Virtual simultaneous administration, after preoxygenation, of a potent sedative agent and a rapidly acting neuromuscular blocking agent to facilitate rapid tracheal intubation
What is the next best step?
Noninvasive Ventilation William Janssen, M.D. Assistant Professor of Medicine National Jewish Health University of Colorado Denver Health Sciences Center What is the next best step? 65 year old female
Advanced Airway Management PRESENTED BY: JOSIAH POIRIER RN, JOHN GRUBER FP-C
Advanced Airway Management PRESENTED BY: JOSIAH POIRIER RN, JOHN GRUBER FP-C Advanced Airway Objectives Advanced airway management is a relatively low frequency, high risk intervention. The following education
Airway Management. Key points. Rapid Sequence Intubation. Rapid Sequence Intubation Recognizing difficult airway Managing difficult airway
Airway Management Prasha Ramanujam and Guy Shochat Department of Emergency Medicine UCSF Medical Center Key points Rapid Sequence Intubation Recognizing difficult airway Managing difficult airway Rapid
CONFLICT OF INTEREST NONE
Airway Dr Albert Buchel MD CCFP EM CAC EM. Assistant Professor, Department of emergency medicine Program Director CCFP EM residency University of Manitoba CONFLICT OF INTEREST NONE AIRWAY TIPS PASSING
Airway Management in the Multiply Traumatized Patient
Airway Management in the Multiply Traumatized Patient Toronto Anesthesia Symposium April 18, 2015 Dr. Jeffrey Wassermann Department of Anesthesia St. Michael s Hospital University of Toronto Airway Management
Randomized Trial of Apneic Oxygenation during Endotracheal Intubation of the Critically Ill
Randomized Trial of Apneic Oxygenation during Endotracheal Intubation of the Critically Ill Matthew W. Semler, MD; David R. Janz, MD, MSc; Robert J. Lentz, MD; Daniel T. Matthews, MD; Brett C. Norman,
RAPID SEQUENCE INTUBATION FOR THE RURAL DOC
Society of Rural Physicians of Canada 26TH ANNUAL RURAL AND REMOTE MEDICINE COURSE ST. JOHN'S NEWFOUNDLAND AND LABRADOR APRIL 12-14, 2018 Dr. Braam de Klerk VICTORIA BC 240 RAPID SEQUENCE INTUBATION FOR
@airwaycam airwaycam.com
It s not just about the tube, its the VAPORS & Resuscitation Sequence Intubation What are our lives except a vapor that appears for a little while and vanishes and passes away? James 4:14 Ventilation Acidosis
Where Emergency Medicine Meets Critical Care: Next Level Resuscitation
Where Emergency Medicine Meets Critical Care: Next Level Resuscitation Rob Green, BSc, MD, DABEM, FRCPC, FRCP(Edin) Professor, Dalhousie University Departments of Emergency Medicine,Critical Care Medicine
MAKING RSI SAFER. Nick Taylor ETU THK 2015
MAKING RSI SAFER Nick Taylor ETU THK 2015 GOALS 1. AIRWAY ASSESSMENT AND PLAN 2. MAXIMALLY PREOXYGENATE 3. HAEMODYNAMIC STABILITY PART 1 : AIRWAY ASSESSMENT AND PLAN LEMON: AIRWAY ASSESS AND PLAN Look
Cricoid pressure: useful or dangerous?
Cricoid pressure: useful or dangerous? Francis VEYCKEMANS Cliniques Universitaires Saint Luc Bruxelles (2009) Controversial issue - Can J Anaesth 1997 JR Brimacombe - Pediatr Anesth 2002 JG Brock-Utne
Joint Theater Trauma System Clinical Practice Guideline
Page 1 of 7 Joint Theater Trauma System Clinical Practice Guideline TRAUMA AIRWAY MANAGEMENT Original Release/Approval 18 Dec 2004 Note: This CPG requires an annual review. Reviewed: May 2012 Approved:
OWN THE AIRWAY. Airway Management Bruce Barry, RN, CEN, CPEN, TCRN, NRP. Paramedic Program
OWN THE AIRWAY Airway Management Bruce Barry, RN, CEN, CPEN, TCRN, NRP The largest detriment to airway management has nothing to do with the patient, but everything to do with you as a provider. PRACTICE..PRACTICE.PRACTICE.
EMS Subspecialty Certification Review Course. Learning Objectives
EMS Subspecialty Certification Review Course 1.1.2 Airway Compromise / Respiratory Failure 1.1.2.1 Devices for securing airway 1.1.2.2 Portable ventilator management 1.1.2.3 Pros and cons of drug assisted
Epiglottoscopy, Positioning, The Neglected Orifice, & Passive Oxygenation
Epiglottoscopy, Positioning, The Neglected Orifice, & Passive Oxygenation Richard M. Levitan, MD Jefferson Medical College Philadelphia PA EPIGLOTTIS: The Anatomic Center of the Airway Start to Finish
by Weingart S, Nickson C, Rabinovich J, Strayer R. version
EMCrit Call/Response Intubation Ch Plan HOp Killers-Hemodynamics, Ox, ph RSI Awake DSI RSA ICP/Vascular Induction Agent/Muscle Relaxant Push-Dose Presss Failed Airway Plan Verbalized Cric-Con Evaluation
Airway Management and The Difficult Airway
Airway Management and The Difficult Airway Gary McCalla, MD, FACEP Medical Director REACH Air Medical Services Services 1 It is not enough to do your best, unless you have prepared to be the best. -John
All bedside percutaneously placed tracheostomies
Page 1 of 5 Scope: All bedside percutaneously placed tracheostomies Population: All ICU personnel Outcomes: To standardize and outline the steps necessary to safely perform a percutaneous tracheostomy
Episode 110 Airway Pitfalls Live from EMU 2018
Episode 110 Airway Pitfalls Live from EMU 2018 With Dr. Scott Weingart Prepared by Anton Helman, May 2018 The last decade has seen a torrent of literature and expert opinion on emergency airway management.
Advanced Airway Management. University of Colorado Medical School Rural Track
Advanced Airway Management University of Colorado Medical School Rural Track Advanced Airway Management Basic Airway Management Airway Suctioning Oxygen Delivery Methods Laryngeal Mask Airway ET Intubation
PEEP recruitment maneuver
Robert M. Rodriguez, MD FAAEM Clinical Professor of Medicine and Emergency Medicine, UCSF Case 1: 40 yo Male restrained driver high speed MVA P 140, RR 40 labored, BP 100/70, O 2 sat 70 Chest wheeze, crackles
Kelowna June 2011 Airway Assessment and Management. Golden, BC
Kelowna June 2011 Airway Assessment and Management Dr. Bruce Starke Golden, BC Not really... I am unable to identify any potential conflict of interest and I am unable to identify any potential conflict
How to Predict and Avoid Airway Disasters. Muhammad Umer Ihsan
How to Predict and Avoid Airway Disasters Muhammad Umer Ihsan Four Key Aspect of Assessing a Difficult Airway Difficult Bag Mask Ventilation Difficult Direct Laryngoscopy Difficult Extra-glottic devices
General Medical Procedure. Emergency Airway Techniques (General Airway Protocol)
General Medical Procedure Appropriate airway management is often the most important intervention a prehospital care provider makes, as ensuring adequate oxygenation and ventilation is crucial to the survival
Emerging Hipsters James Webley, MD, FACEP
Hip dislocations Posterior Hip Dislocation 85% of hip dislocations High energy injuries MVA most common mechanism Symptoms Pain hip or thigh Short leg Flexion of hip Internal rotation Adduction Numbness
DON T PRACTICE UNTIL YOU GET IT RIGHT. PRACTICE UNTIL YOU CAN T GET IT WRONG.
ADVANCED AIRWAY MANAGEMENT AND THE DIFFICULT AIRWAY DON T PRACTICE UNTIL YOU GET IT RIGHT. PRACTICE UNTIL YOU CAN T GET IT WRONG. The Decision to Intubate n Can the patient protect their airway? n Can
Training. Continuous Positive Airway Pressure (CPAP)
Training The training module will follow the national standard curriculum as it relates to the application and use of CPAP. The proposed curriculum will closely resemble the following algorithm utilizing
VUMC Multidisciplinary Surgical Critical Care Service
VUMC Multidisciplinary Surgical Critical Care Service SICU Standard Operating Procedure: Guidelines for Intubation I. Definition Intubation is required for SICU patients who cannot maintain a patent airway,
Unanticipated difficult tracheal intubation - during routine induction of anaesthesia in an adult patient
Unanticipated difficult tracheal intubation - during routine induction of anaesthesia in an adult patient Direct laryngoscopy Any problems Call for help Plan A: Initial tracheal intubation plan Direct
Airway/Breathing. Chapter 5
Airway/Breathing Chapter 5 Airway/Breathing Introduction Skillful, rapid assessment and management of airway and ventilation are critical to preventing morbidity and mortality. Airway compromise can occur
AIRWAY MANAGEMENT AND VENTILATION
AIRWAY MANAGEMENT AND VENTILATION D1 AIRWAY MANAGEMENT AND VENTILATION Basic airway management and ventilation The laryngeal mask airway and Combitube Advanced techniques of airway management D2 Basic
3/30/12. Luke J. Gasowski BS, BSRT, NREMT-P, FP-C, CCP-C, RRT-NPS
Luke J. Gasowski BS, BSRT, NREMT-P, FP-C, CCP-C, RRT-NPS 1) Define and describe ETCO 2 2) Explain methods of measuring ETCO 2 3) Describe various clinical applications of ETCO 2 4) Describe the relationship
Orotracheal Intubation
T h e n e w e ng l a nd j o u r na l o f m e dic i n e videos in clinical medicine Orotracheal Intubation Christopher Kabrhel, M.D., Todd W. Thomsen, M.D., Gary S. Setnik, M.D., and Ron M. Walls, M.D.
Facilitating EndotracheaL Intubation by Laryngoscopy technique and Apneic Oxygenation Within the Intensive Care Unit (FELLOW)
Facilitating EndotracheaL Intubation by Laryngoscopy technique and Apneic Oxygenation Within the Intensive Data Analysis Plan: Apneic Oxygenation vs. No Apneic Oxygenation Background Critically ill patients
INternational observational study To Understand the impact and BEst practices of airway management in critically ill patients CASE REPORT FORM
INternational observational study To Understand the impact and BEst practices of airway management in critically ill patients Study acronym identifier: INTUBE CASE REPORT FORM Centre ID number: Patient
Caring For the ICU Boarder. Kami M. Hu, MD Depts of Emergency & Internal Medicine University of Maryland SOM
Caring For the ICU Boarder Kami M. Hu, MD Depts of Emergency & Internal Medicine University of Maryland SOM I have no relevant financial relationships with the manufacturer(s) of any commercial product(s)and/or
Question: Is this patient an infant? A patient less than 12 months old is considered an infant. Please check the box next to the appropriate choice.
Question: Date of Intubation (Month, Day, Year): Question: Date of Data Entry This should be within 4 weeks to the day of intubation: Question: Is this patient an infant? A patient less than 12 months
Airway Management Adult
Airway Management Adult Goals: Provide effective oxygenation and ventilation; recognize and alleviate respiratory distress or failure; provide necessary interventions quickly and safely to patients who
Airway, Anesthesia, Analgesia
Airway, Anesthesia, Analgesia Been There, but Hope to Never Do That Again: Averting Common Airway Errors MO - 36/ 0.5 Hour(s) Faculty: Calvin A. Brown, III, MD Through the use of real-life critical airway
Other methods for maintaining the airway (not definitive airway as still unprotected):
Page 56 Where anaesthetic skills and drugs are available, endotracheal intubation is the preferred method of securing a definitive airway. This technique comprises: rapid sequence induction of anaesthesia
RAPID SEQUENCE INTUBATION FOR THE RURAL DOC
Society of Rural Physicians of Canada 26TH ANNUAL RURAL AND REMOTE MEDICINE COURSE ST. JOHN'S NEWFOUNDLAND AND LABRADOR APRIL 12-14, 2018 Dr. Braam de Klerk VICTORIA BC 240 RAPID SEQUENCE INTUBATION FOR
Airway/Breathing. Chapter 5
Airway/Breathing Chapter 5 Airway/Breathing Introduction Skillful, rapid, assessment and management of airway and ventilation are critical to preventing morbidity and mortality. Airway compromise can occur
Airway/Breathing. Chapter 5
Airway/Breathing Chapter 5 Airway/Breathing Introduction Rapid assessment and management of airway and ventilation are critical to preventing morbidity and mortality. Airway compromise can occur rapidly
EMS Subspecialty Certification Review Course
EMS Subspecialty Certification Review Course 1.1.2 Airway Compromise / Respiratory Failure 1.1.2.1 Devices for securing airway 1.1.2.2 Portable ventilator management 1.1.2.3 Pros and cons of drug assisted
Consensus Statement: ADULT Rapid Sequence Intubation and Post-Intubation Analgesia and Sedation for Major Trauma Patients.
Consensus Statement: ADULT Rapid Sequence Intubation and Post-Intubation and Sedation for Major Trauma Patients Participants: Dr. James French, SJRH EM and NBTP Sue Benjamin RN, NBTP Julie Ringuette RN,
yregion I EMERGENCY MEDICAL SERVICES STANDING MEDICAL ORDERS EMT Basic SMO: Airway Management
yregion I EMERGENCY MEDICAL SERVICES STANDING MEDICAL ORDERS EMT Basic SMO: Airway Management Overview: Managing a patient s airway may be necessitated due to upper or lower airway obstruction, inadequate
Scenario title. Pear Shaped- prepare for intubation on the ward. Designed for (specific group) ICU MET team. Scenario Design team.
Scenario title Pear Shaped- prepare for intubation on the ward Designed for (specific group) ICU MET team Scenario Design team Name Maurice Le Guen Cameron Knott Organisation Austin Hospital Date of creation
NON-INVASIVE VENTILATION. Lijun Ding 23 Jan 2018
NON-INVASIVE VENTILATION Lijun Ding 23 Jan 2018 Learning objectives What is NIV The difference between CPAP and BiPAP The indication of the use of NIV Complication of NIV application Patient monitoring
INTUBATION APPENDIX II. INDICATIONS AND CONTRAINDICATIONS II. COMPLICATIONS: APPENDIX: 2 TITLE: INTUBATION PROCEDURES. REVISED: May 1, 2016
APPENDIX: TITLE: PROCEDURES REVISED: May 1, 016 I. BACKGROUND Advanced Airway Procedures and competency are the cornerstones of Paramedicine. True competency involves knowing not only how to control the
Physical Exam. T 97.4, HR 76, BP 90/51, Sat 96% Lethargic Lungs clear Heart regular Abdomen soft, epigastric tenderness, distension
Case Report 58yM with non-bilious non-bloody vomiting for one week. Also reported epigastric abdominal pain. PMH: obesity, HTN, HIV, prior CVA with left sided weakness, bipolar disorder PSH: none SH: former
Advanced airway management in adults
Page 1 of 11 Official reprint from UpToDate www.uptodate.com 2011 UpToDate Advanced airway management in adults Author Aaron E Bair, MD, MSc, FAAEM, FACEP Disclosures Section Editor Ron M Walls, MD, FRCPC,
Airway Workshop Lecture. University of Ottawa
Airway Workshop Lecture Department of Anesthesiology University of Ottawa Overview Ventilation Airway assessment Difficult airways Airway management equipment aids Intubation/Improving Intubation Success
Keeping Patients Off the Vent: Bilevel, HFNC, Neither?
Keeping Patients Off the Vent: Bilevel, HFNC, Neither? Robert Kempainen, MD Pulmonary and Critical Care Medicine Hennepin County Medical Center University of Minnesota School of Medicine Objectives Summarize
ARDS: The Evidence. Topics. New definition Breaths: Little or Big? Wet or Dry? Moving or Still? Upside down or Right side up?
ARDS: The Evidence Todd M Bull MD Professor of Medicine Division of Pulmonary Sciences and Critical Care Division of Cardiology Director Pulmonary Vascular Disease Center Director Center for Lungs and
Learning Objectives. 1. Indications versus contra-indications 2. CPAP versus NiVS 3. Clinical evidence
Learning Objectives 1. Indications versus contra-indications 2. CPAP versus NiVS 3. Clinical evidence Pre-hospital Non-invasive vventilatory support Marc Gillis, MD Imelda Bonheiden Our goal out there
Beyond the Golden Hour: Caring for the ICU Boarder
Beyond the Golden Hour: Caring for the ICU Boarder Kami M. Hu, MD Dept. of Emergency Medicine Dept. of Pulmonology & Critical Care University of Maryland SOM I have no relevant financial relationships
Airway Anatomy. Soft palate. Hard palate. Nasopharynx. Tongue. Oropharynx. Hypopharynx. Thyroid cartilage
Airway Anatomy Hard palate Soft palate Tongue Nasopharynx Oropharynx Hypopharynx Thyroid cartilage Airway Anatomy Hyoid bone Thyroid cartilage Cricoid cartilage Trachea Cricothyroid membrane Airway Anatomy
Idaho EMSPC Scope of Practice OLD (ISC) Curriculum License Levels NEW 2011 IEC Curriculum License Levels
AIRWAY / VENTILATION / OXYGENATION Idaho EMSPC Scope of Practice - OLD (ISC) Curriculum License Levels NEW IEC Curriculum License Levels Effective July 1, 2016 1 View of All Levels Across EMR- 1-1-2012)
ARDS: an update 6 th March A. Hakeem Al Hashim, MD, FRCP SQUH
ARDS: an update 6 th March 2017 A. Hakeem Al Hashim, MD, FRCP SQUH 30M, previously healthy Hx: 1 week dry cough Gradually worsening SOB No travel Hx Case BP 130/70, HR 100/min ph 7.29 pco2 35 po2 50 HCO3
J O IN T T R A UM A SY S T E M C L IN I C A L P R A C T IC E G U ID E L I N E (J T S C PG
JOINT TRAUMA SYSTEM CLINICAL PRACTIC E GUIDELINE (JTS CPG ) Airway Management of Traumatic Injuries (CPG: 39) To optimize the airway management for patients with traumatic injury in the operational medical
Prepared by : Bayan Kaddourah RN,MHM. GICU Clinical Instructor
Mechanical Ventilation Prepared by : Bayan Kaddourah RN,MHM. GICU Clinical Instructor 1 Definition Is a supportive therapy to facilitate gas exchange. Most ventilatory support requires an artificial airway.
Dyspnea: Should we use BIPAP?
Dyspnea: Should we use BIPAP? Thomas R. Gildea MD, MS FCCP Head Section of Bronchoscopy Respiratory Institute Transplant Center Disclosure SuperDimension Inc. PI for single center study Others: Aeris,
AVOIDING THE CRASH 3: RELAX, OPTIMAL POST-AIRWAY MANAGEMENT AVOIDING THE CRASH: OPTIMIZE YOUR PRE, PERI, AND POST AIRWAY MANAGEMENT
AVOIDING THE CRASH: OPTIMIZE YOUR PRE, PERI, AND POST AIRWAY MANAGEMENT Robert J. Vissers MD Chief, Emergency Medicine, Quality Chair, Legacy Emanuel Medical Center Adjunct Associate Professor, OHSU Portland,
When I started. 10/27/2009. Gerald Wydro, MD Clinical Associate Professor Emergency Medicine Temple University School of Medicine
When I started. Gerald Wydro, MD Clinical Associate Professor Emergency Medicine Temple University School of Medicine When I started. When I started. When I started. When I started. How To Make A Fertile
GE Healthcare. Non Invasive Ventilation (NIV) For the Engström Ventilator. Relief, Relax, Recovery
GE Healthcare Non Invasive Ventilation (NIV) For the Engström Ventilator Relief, Relax, Recovery COPD is currently the fourth leading cause of death in the world, and further increases in the prevalence
Joint Trauma System. Airway Trauma Injury Management
Joint Trauma System Airway Trauma Injury Management 1 Agenda Contributors Purpose Summary Key Principles of CPG Performance Improvement (PI) Monitoring References List of Appendices in CPG 2 Contributors
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
Available ONLY at: BMC-B BMC-D BMC-N BMC-S Intubation Phase Notify Therapy for STAT intubation SUB Rapid Sequence Induction(SUB)* ***The above subphase is available at the end of the powerplan under the
CSIM annual meeting Acute respiratory failure. Dr. John Ronald, FRCPC Int Med, Resp, CCM. October 10, 2018
CSIM annual meeting - 2018 Acute respiratory failure Dr. John Ronald, FRCPC Int Med, Resp, CCM. October 10, 2018 NRGH affiliated with UBC medicine Disclosures None relevant to this presentation. Also no
Chapter 10. Objectives. Objectives 01/09/2013. Airway Management, Artificial Ventilation, and Oxygenation
Chapter 10 Airway Management, Artificial Ventilation, and Oxygenation Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights
10 TIPS. for Effective Airway Management and Ventilation. From BLS to ALS, what are the best current practices?
There are two ways to take the CE test that accompanies this article and receive 1 hour of CE credit accredited by CECBEMS: 1. Go online to EMSWorld.com/cetest to download a PDF of the test. The PDF has
Airway Management. Teeradej Kuptanon, MD
Airway Management Teeradej Kuptanon, MD Outline Anatomy Detect difficult airway Rapid sequence intubation Difficult ventilation Difficult intubation Surgical airway access ICU setting Intubation Difficult
ARTICLE IN PRESS. doi: /j.jemermed PREOXYGENATION, REOXYGENATION, AND DELAYED SEQUENCE INTUBATION IN THE EMERGENCY DEPARTMENT
doi:10.1016/j.jemermed.2010.02.014 The Journal of Emergency Medicine, Vol. xx, No. x, pp. xxx, 2010 Copyright 2010 Elsevier Inc. Printed in the USA. All rights reserved 0736-4679/10 $ see front matter
APRV Ventilation Mode
APRV Ventilation Mode Airway Pressure Release Ventilation A Type of CPAP Continuous Positive Airway Pressure (CPAP) with an intermittent release phase. Patient cycles between two levels of CPAP higher
Redundancy of safety (primary and backup chute) Planned stepwise approach to deploy 1 ary chute Simple, fast, easy backup chute deployment Attention
Rapid Sequence Intubation John Bradley, MD Metropolitan Hospital May 30, 2012 1 Lessons from Skydiving Levitan RM. Patient safety in emergency airway management and rapid sequence intubation: metaphorical
Overview. Chapter 37. Advanced Airway Techniques. Sellick Maneuver 9/11/2012
Chapter 37 Advanced Airway Techniques Slide 1 Sellick Maneuver Purpose Anatomic Location Technique Special Considerations Overview Advanced Airway Management of Adults Esophageal Tracheal Combitubes Tracheal
Capnography. Capnography. Oxygenation. Pulmonary Physiology 4/15/2018. non invasive monitor for ventilation. Edward C. Adlesic, DMD.
Capnography Edward C. Adlesic, DMD University of Pittsburgh School of Dental Medicine 2018 North Carolina Program Capnography non invasive monitor for ventilation measures end tidal CO2 early detection
ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS
DRUG AND TREATMENT Intubation Phase Notify Therapy for STAT intubation Medications SUB Rapid Sequence Induction (SUB)* ***Reminder: Order SUB Rapid Sequence Induction (SUB) on a separate form*** lidocaine
Crack Cast show notes. Episode 1.
Decision to tube 1. Failure to maintain or protect the airway Can't handle gastric and oral secretions 2. Failure to ventilate or oxygenate ABG rarely useful 3. Pts' anticipated clinical course and likelihood
Basics of NIV. Dr Shrikanth Srinivasan MD,DNB,FNB,EDIC. Consultant, Critical Care Medicine Medanta, The Medicity
Basics of NIV Dr Shrikanth Srinivasan MD,DNB,FNB,EDIC Consultant, Critical Care Medicine Medanta, The Medicity Objectives: Definitions Advantages and Disadvantages Interfaces Indications Contraindications
AIRWAY MANAGEMENT SUZANNE BROWN, CRNA
AIRWAY MANAGEMENT SUZANNE BROWN, CRNA OBJECTIVE OF LECTURE Non Anesthesia Sedation Providers Review for CRNA s Informal Questions encouraged 2 AIRWAY MANAGEMENT AWARENESS BASICS OF ANATOMY EQUIPMENT 3
Pearls and Pitfalls of Rapid Sequence Intubation
Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/clinicians-roundtable/pearls-and-pitfalls-of-rapid-sequenceintubation/3829/
I. Subject: Pressure Support Ventilation (PSV) with BiPAP Device/Nasal CPAP
I. Subject: Pressure Support Ventilation (PSV) with BiPAP Device/Nasal CPAP II. Policy: PSV with BiPAP device/nasal CPAP will be initiated upon a physician's order by Respiratory Therapy personnel trained
Respiratory insufficiency in bariatric patients
Respiratory insufficiency in bariatric patients Special considerations or just more of the same? Weaning and rehabilation conference 6th November 2015 Definition of obesity Underweight BMI< 18 Normal weight
Haut debit nasal ou BiPAP? Laurent Brochard Toronto
Haut debit nasal ou BiPAP? Laurent Brochard Toronto Conflicts of interest Our clinical research laboratory has received research grants for clinical trials from the following companies: General Electric
Evaluation of Effect of Breathe Ventilation System on Work of Breathing in COPD patients. Matthew Cohn, M.D.
Evaluation of Effect of Breathe Ventilation System on Work of Breathing in COPD patients Matthew Cohn, M.D. 1 11/4/2013 Disclosure Slide- Matthew Cohn, M.D. Personal financial relationships with commercial
NON INVASIVE LIFE SAVERS. Non Invasive Ventilation (NIV)
Table 1. NIV: Mechanisms Of Action Decreases work of breathing Increases functional residual capacity Recruits collapsed alveoli Improves respiratory gas exchange Reverses hypoventilation Maintains upper
Bronchoscopy SICU Protocol
Bronchoscopy SICU Protocol Updated January 2013 Outline Clinical indications Considerations Preparation Bronchoscopy technique Bronchoalveolar Lavage (BAL) Post-procedure Purpose Bronchoscopy is a procedure
Breathe easier. Philips WhisperFlow CPAP system provides non-invasive respiratory care designed for EMS. sense and simplicity
Breathe easier Philips WhisperFlow CPAP system provides non-invasive respiratory care designed for EMS sense and simplicity Designed for EMS When caregivers respond to an emergency, time is essential and
CASE REPORT FORM (v )
INternational observational study To Understand the impact and BEst practices of airway management in critically ill patients Study acronym identifier: INTUBE CASE REPORT FORM (v 1.2 30.09.18) SITE INFORMATION
High Flow Humidification Therapy, Updates.
High Flow Humidification Therapy, Updates. Bernardo Selim, M.D. I have no relevant financial relationships to disclose. Assistant Professor, Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic What
Interesting Capnography Cases
Interesting Capnography Cases Mike McEvoy, PhD, NRP, RN, CCRN Cardiac Surgical ICU RN & Chair Resuscitation Committee Albany Medical Center EMS Coordinator Saratoga County, NY www.mikemcevoy.com Outline
Case 1: Fast and noisy. The Ins and Outs of the Pediatric Airway. Airway: anatomic differences. Objectives 2/16/2014
Case 1: Fast and noisy The Ins and Outs of the Pediatric Airway Judith Klein, MD, FACEP Assistant Professor of Emergency Medicine UCSF-SFGH Department of Emergency Medicine 8 month old BIB parents for