(Non)-invasive ventilation: transition from PICU to home. Christian Dohna-Schwake
|
|
|
- Eugenia Hamilton
- 5 years ago
- Views:
Transcription
1 (Non)-invasive ventilation: transition from PICU to home Christian Dohna-Schwake
2 Increased use of NIV in PICUs over last 15 years First choice of respiratory support in many diseases Common temporary indications: postextubation failure, acute hypoxic and hypercapnic respiratory failure Bronchiolitis, status asthmaticus, immunocompromised patients with respiratory failure, after extended surgery (cardiac, liver tx)
3 Acute respiratory failure: NIV vs. intubation Borckink I, Acta Paediatrica 2014
4 Acute respiratory failure: NIV vs. standard care Faster reduction of RR Yanez et al.: PCCM 2008
5 Wolfler et al. PCCM 2016
6 150/197 patients initiated on PICU 2/3 neuromuscular disorders, 17% central nervous system disorders, 6% chronic pulmonary diseases, 11% miscellaneous Invasive ventilation decreased from 100 to 39% over decades
7
8 Patients on MV difficult to wean Neuromuscular disorders Impaired central drive Disorders of the lung Obesity hypoventilation Obstructive sleep apnea Severe thoracic deformities
9 Differences in circumstances (comparison of two pediatric hospitals with PICUs) Essen Bicetre 8 bed PICU 20 bed PICU (including surgical IMC) Pediatric pulmonology Pediatric neurology IMC with >100 cases of home MV/year Sleep studies available Respiratory therapist Large experience Initiation and control of HMV on IMC No pediatric pulmonology Pediatric neurology No (specialised) IMC No sleep studies available No specialised physiotherapy Little experience Initiation and control of HMV on ICU
10 Patient factors to consider Mode of ventilation (invasive, non-invasive) Length of ventilation (sleep 24 hours) Age of patient Mobility of patient Disease / oxygen dependency / cough insufficiency
11 Aims of discharge and transfer of child on MV Safe As fast as possible Kept privacy for child and family (no continuation of ICU at home) Interdisciplinary approach (ICU, pneumology, pediatric neurology, respiratory therapist, rehabilitation, family)
12 Can Respir J 2011
13 Medically stable Hemodynamics Nutrition Ventilation and oxygenation in normal ranges without changes of ventilator necessary
14 Motivated Family and patient willing to be part of the community
15 Adequate home setting Room for patient and equipment Time for patient care
16 Sufficient caregiver support Parents or caregivers willing to participate in medical support Additional need of medical support identified and provided (e. g. home nursing)
17 Adequate financial resources Health insurance coverage Other sources of financial resources and assistance identified
18 Appropriate equipment Ventilator (backup, battery in 24-hour-dependency) Oxygen supply Monitoring (saturation) Airway secretion management (assited coughing devices, suctioning device) Masks, tubes, suctioning catheters as substitutes Other medications
19 Initial training Caregivers/parents know how to handle devices, masks etc. Other medical caregivers (home nursing) experienced
20 Access to health care support Follow-up care in specialised ventilation unit Home care organized Help for medical emergencies provided
21 Neurology, mobilisation Referring staff, ventilation unit Home care, pediatrician Ventilation
22 tracheostomy mask procedures Devices: Suctioning, Cough assist, inhalation, oxygen, humidification
23 nutrition medication
24 Control before transfer HMV effective (meets treatment goals)? Home prepared? Caregivers identified and trained? Equipment complete and functioning? Access to health care support available in case of emergency and for regular control?
25 Optimal approach of patient on PICU with need of HMV to transfer at home Treatment and stabilisation of acute respiratory deterioration on PICU Transfer to specialised respiratory unit for HMV Optimization of respiratory support and organisation of caregiver support, equipment and health care access Rehabilitation unit? Short term care in specialized unit outside hospital? Transfer home
Airway Clearance Devices
Print Page 1 of 11 Wisconsin.gov home state agencies subject directory department of health services Search Welcome» August 2, 2018 5:18 PM Program Name: BadgerCare Plus and Medicaid Handbook Area: Durable
POLICY. Number: Title: APPLICATION OF NON INVASIVE VENTILATION FOR ACUTE RESPIRATORY FAILURE. Authorization
POLICY Number: 7311-60-024 Title: APPLICATION OF NON INVASIVE VENTILATION FOR ACUTE RESPIRATORY FAILURE Authorization [ ] President and CEO [ x ] Vice President, Finance and Corporate Services Source:
Web Appendix 1: Literature search strategy. BTS Acute Hypercapnic Respiratory Failure (AHRF) write-up. Sources to be searched for the guidelines;
Web Appendix 1: Literature search strategy BTS Acute Hypercapnic Respiratory Failure (AHRF) write-up Sources to be searched for the guidelines; Cochrane Database of Systematic Reviews (CDSR) Database of
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
Ron Hosp, MS-HSA, RRT Regional Respiratory Specialist. This program has been approved for 1 hour of continuing education credit.
Ron Hosp, MS-HSA, RRT Regional Respiratory Specialist This program has been approved for 1 hour of continuing education credit. Course Objectives Identify at least four goals of home NIV Identify candidates
Section: Universal Benefit Programs. Respiratory Equipment Program
Section: Universal Benefit Programs Date Reviewed January 2018 Drug Plan & Extended Benefits Respiratory Equipment Program INTENT The Respiratory Equipment Program offers the loan of a selection of respiratory
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
Pediatric Patients. Neuromuscular Disease. Teera Kijmassuwan, MD Phetcharat Netmuy, B.N.S., MA Oranee Sanmaneechai, MD : Preceptor
Patient Management Pediatric Patients with Neuromuscular Disease Teera Kijmassuwan, MD Phetcharat Netmuy, B.N.S., MA Oranee Sanmaneechai, MD : Preceptor Case Thai boy 1 year old Present with Respiratory
BTS/ICS Guidelines for the ventilatory management of acute hypercapnic respiratory failure in adults
BTS/ICS Guidelines for the ventilatory management of acute hypercapnic respiratory failure in adults British Thoracic Society Intensive Care Society Introduction Acute Hypercapnic Respiratory Failure (AHRF)
Home Mechanical Ventilation
The International Convention Centre (ICC), Birmingham 11 12 September 2017 Home Mechanical Ventilation Martin Latham Nurse Specialist in Sleep Disordered Breathing St James s University Hospital Leeds
Bi-Level Therapy: Boosting Comfort & Compliance in Apnea Patients
Bi-Level Therapy: Boosting Comfort & Compliance in Apnea Patients Objectives Describe nocturnal ventilation characteristics that may indicate underlying conditions and benefits of bilevel therapy for specific
Charisma High-flow CPAP solution
Charisma High-flow CPAP solution Homecare PNEUMOLOGY Neonatology Anaesthesia INTENSIVE CARE VENTILATION Sleep Diagnostics Service Patient Support charisma High-flow CPAP solution Evidence CPAP therapy
Noninvasive Mechanical Ventilation in Children ศ.พญ.อร ณวรรณ พฤทธ พ นธ หน วยโรคระบบหายใจเด ก ภาคว ชาก มารเวชศาสตร คณะแพทยศาสตร โรงพยาบาลรามาธ บด
Noninvasive Mechanical Ventilation in Children ศ.พญ.อร ณวรรณ พฤทธ พ นธ หน วยโรคระบบหายใจเด ก ภาคว ชาก มารเวชศาสตร คณะแพทยศาสตร โรงพยาบาลรามาธ บด Noninvasive Mechanical Ventilation Provide support without
Index. sleep.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acquired central hypoventilation syndrome, NPPV in children with, 475 Acute cardiogenic pulmonary edema, PAP therapy in, 394 395 Adaptive
Respiratory Management- Your Questions Answered! Michelle Chatwin, PhD Consultant Physiotherapist
Respiratory Management- Your Questions Answered! Michelle Chatwin, PhD Consultant Physiotherapist Why Are People Affected Differently Neuromuscular Disease; A Spectrum Its severity varies widely within
Physiotherapy on the Intensive Care Unit. Information for patients, their family and carers
Physiotherapy on the Intensive Care Unit Information for patients, their family and carers A team of Specialist Physiotherapists works in the Intensive Care Units within the Oxford University Hospitals
NI 60. Non-invasive ventilation without compromise. Homecare Pneumology Neonatology Anaesthesia. Sleep Diagnostics Service Patient Support
NI 60 Non-invasive ventilation without compromise Homecare Pneumology Neonatology Anaesthesia INTENSIVE CARE VENTILATION Sleep Diagnostics Service Patient Support NI 60 Non-invasive ventilation without
AFCH NEUROMUSCULAR DISORDERS (NMD) PROTOCOL
AFCH NEUROMUSCULAR DISORDERS (NMD) PROTOCOL A. Definition of Therapy: 1. Cough machine: 4 sets of 5 breaths with a goal of I:E pressures approximately the same of 30-40. Inhale time = 1 second, exhale
Transcutaneous Monitoring and Case Studies
Transcutaneous Monitoring and Case Studies Objectives General concept, applications and principles of operation Role of TCM in clinical settings Role of TCM in home care settings Need for continuous TCM
Policy Specific Section: October 1, 2010 January 21, 2013
Medical Policy Bi-level Positive Airway Pressure (BPAP/NPPV) Type: Medical Necessity/Not Medical Necessity Policy Specific Section: Durable Medical Equipment Original Policy Date: Effective Date: October
Home Pulse Oximetry for Infants and Children
Last Review Date: April 21, 2017 Number: MG.MM.DM.12aC2v2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth
Interfacility Protocol Protocol Title:
Interfacility Protocol Protocol Title: Mechanical Ventilator Monitoring & Management Original Adoption Date: 05/2009 Past Protocol Updates 05/2009, 12/2013 Date of Most Recent Update: March 23, 2015 Medical
The more you know, the more you can do
The more you know, the more you can do How Duchenne muscular dystrophy affects lung function As life expectancy of patients with Duchenne muscular dystrophy (DMD) has increased over the past few decades,
BTS Guideline for Home Oxygen use in adults Appendix 9 (online only) Key Questions - PICO 10 December 2012
BTS Guideline for Home Oxygen use in adults Appendix 9 (online only) Key Questions - PICO 10 December 2012 Evidence base for Home Oxygen therapy in COPD, non-copd respiratory disease and nonrespiratory
Recent Advances in Respiratory Medicine
Recent Advances in Respiratory Medicine Dr. R KUMAR Pulmonologist Non Invasive Ventilation (NIV) NIV Noninvasive ventilation (NIV) refers to the administration of ventilatory support without using an invasive
Subspecialty Rotation: Anesthesia
Subspecialty Rotation: Anesthesia Faculty: John Heaton, M.D. GOAL: Maintenance of Airway Patency and Oxygenation. Recognize and manage upper airway obstruction and desaturation. Recognize and manage upper
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.
TTC Catalog - Respiratory Care (RES)
2018-2019 TTC Catalog - Respiratory Care (RES) RES 110 - Cardiopulmonary Science I This course focuses on assessment, treatment evaluation of patients with cardiopulmonary disease. RES 121 Restrictions:
NIV use in ED. Dr. Khalfan AL Amrani Emergency Resuscitation Symposium 2 nd May 2016 SQUH
NIV use in ED Dr. Khalfan AL Amrani Emergency Resuscitation Symposium 2 nd May 2016 SQUH Outline History & Introduction Overview of NIV application Review of proven uses of NIV History of Ventilation 1940
By Mark Bachand, RRT-NPS, RPFT. I have no actual or potential conflict of interest in relation to this presentation.
By Mark Bachand, RRT-NPS, RPFT I have no actual or potential conflict of interest in relation to this presentation. Objectives Review state protocols regarding CPAP use. Touch on the different modes that
F: Respiratory Care. College of Licensed Practical Nurses of Alberta, Competency Profile for LPNs, 3rd Ed. 59
F: Respiratory Care College of Licensed Practical Nurses of Alberta, Competency Profile for LPNs, 3rd Ed. 59 Competency: F-1 Airway Management F-1-1 F-1-2 F-1-3 F-1-4 F-1-5 Demonstrate knowledge and ability
Noninvasive Ventilation: Non-COPD Applications
Noninvasive Ventilation: Non-COPD Applications NONINVASIVE MECHANICAL VENTILATION Why Noninvasive Ventilation? Avoids upper A respiratory airway trauma system lacerations, protective hemorrhage strategy
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
H: Respiratory Care. Saskatchewan Association of Licensed Practical Nurses, Competency Profile for LPNs, 3rd Ed. 79
H: Respiratory Care Saskatchewan Association of Licensed Practical Nurses, Competency Profile for LPNs, 3rd Ed. 79 Competency: H-1 Airway Management H-1-1 H-1-2 H-1-3 H-1-4 H-1-5 Demonstrate knowledge
Lumis Tx: the all-in-one hospital ventilation solution
Lumis Tx: the all-in-one hospital ventilation solution The Lumis Tx is a multi-purpose non-invasive ventilator that treats the full range of respiratory conditions and is suitable for a variety of hospital
Dr. CK NG Department of Medicine Queen Elizabeth Hospital Kowloon Central Cluster
Ng CK, O WH, Lit MPK, Lee KH, Chan HF, Chan YC, Cheung YF, Hui YT, Chu S, Chong HM, Yu David, Chan JHM and Chan JWM Dr. CK NG Department of Medicine Queen Elizabeth Hospital Kowloon Central Cluster Neuromuscular
Non-invasive Ventilation protocol For COPD
NHS LANARKSHIRE MONKLANDS HOSPITAL Non-invasive Ventilation protocol For COPD April 2017 S Baird Review Date: Oct 2019 Approved by Medical Directorate Indications for Non-Invasive Ventilation (NIV) NIV
Early and Structured Rehabilitation Team Collaboration. David McWilliams Clinical Specialist Physiotherapist - UHB
Early and Structured Rehabilitation Team Collaboration David McWilliams Clinical Specialist Physiotherapist - UHB Start early Moving through milestones Schweikert et al (2009) Increase frequency of higher
Weaning and extubation in PICU An evidence-based approach
Weaning and extubation in PICU An evidence-based approach Suchada Sritippayawan, MD. Div. Pulmonology & Crit Care Dept. Pediatrics Faculty of Medicine Chulalongkorn University Kanokporn Udomittipong, MD.
Sleep Apnea and ifficulty in Extubation. Jean Louis BOURGAIN May 15, 2016
Sleep Apnea and ifficulty in Extubation Jean Louis BOURGAIN May 15, 2016 Introduction Repetitive collapse of the upper airway > sleep fragmentation, > hypoxemia, hypercapnia, > marked variations in intrathoracic
Oxygenation. Chapter 45. Re'eda Almashagba 1
Oxygenation Chapter 45 Re'eda Almashagba 1 Respiratory Physiology Structure and function Breathing: inspiration, expiration Lung volumes and capacities Pulmonary circulation Respiratory gas exchange: oxygen,
Approach to type 2 Respiratory Failure
Approach to type 2 Respiratory Failure Changing Nature of NIV Not longer just the traditional COPD patients Increasingly Obesity Neuromuscular Pneumonias 3 fold increase in patients with Ph 7.25 and below
Interdisciplinary Care of the Patient with Amyotrophic Lateral Sclerosis Respiratory Therapy Care
Peggy Cox, RRT, RN Frazier Rehab Institute Pulmonary Rehab Interdisciplinary Care of the Patient with Amyotrophic Lateral Sclerosis Respiratory Therapy Care Disclosure I have the following relevant financial
Early Rehabilitation in the ICU: Do We Still Need Chest Physiotherapy?
Early Rehabilitation in the ICU: Do We Still Need Chest Physiotherapy? Michelle Kho, PT, PhD Assistant Professor, School of Rehabilitation Science, McMaster University Adjunct Assistant Professor, Department
Mechanical Ventilation of the Patient with Neuromuscular Disease
Mechanical Ventilation of the Patient with Neuromuscular Disease Dean Hess PhD RRT Associate Professor of Anesthesia, Harvard Medical School Assistant Director of Respiratory Care, Massachusetts General
Respiratory care and ventilation
Respiratory care and ventilation There are many different neuromuscular conditions in which weakness of the breathing muscles requires monitoring and treatment and may eventually need some form of mechanical
Home Mechanical Ventilation:
Home Mechanical Ventilation: A Global A Global View View Nicholas Hill MD Tufts Medical Center Boston MA Nicholas S Hill MD Tufts Medical Center Boston, MA Disclosures Research Grants MAB Breathe Technologies
PedsCases Podcast Scripts
PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Non-Invasive Ventilation in Pediatric Medicine. These podcasts are designed to give medical students an overview of key
Difficult weaning from mechanical ventilation
Difficult weaning from mechanical ventilation Paolo Biban, MD Director, Neonatal and Paediatric Intensive Care Unit Division of Paediatrics, Major City Hospital Azienda Ospedaliera Universitaria Integrata
Neuromuscular diseases (NMDs) include both hereditary and acquired diseases of the peripheral neuromuscular system. They are diseases of the
Neuromuscular diseases (NMDs) include both hereditary and acquired diseases of the peripheral neuromuscular system. They are diseases of the peripheral nerves (neuropathies and anterior horn cell diseases),
Bergen Community College Division of Health Professions Department of Respiratory Care Fundamentals of Respiratory Critical Care
Bergen Community College Division of Health Professions Department of Respiratory Care Fundamentals of Respiratory Critical Care Date Revised: January 2015 Course Description Student Learning Objectives:
Emergency)tracheostomy)management)/)Patent)upper)airway)
Emergency)tracheostomy)management)/)Patent)upper)airway) Call,for,airway,expert,help,,Look,,listen,&,feel,at,the,mouth,and,tracheostomy) A)Mapleson)C)system)(e.g.) Waters)circuit ))may)help)assessment)if)available)
Emergency Medicine High Velocity Nasal Insufflation (Hi-VNI) VAPOTHERM POCKET GUIDE
Emergency Medicine High Velocity Nasal Insufflation (Hi-VNI) VAPOTHERM POCKET GUIDE Indications for Vapotherm High Velocity Nasal Insufflation (Hi-VNI ) administration, the patient should be: Spontaneously
MedStar Health considers Continuous Home Pulse Oximetry medically necessary for the following indications:
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.006.MH Continuous Home Pulse Oximetry This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP CSNP MedStar
Maria Tracey, Director-Perioperative and Elaine Warren, Directory-Surgery Level. III (Three)
PAGE 1/6 MANAGEMENT OF ADULT SURGICAL CLIENTS WITH KNOWN OR SUSPECTED OBSTRUCTIVE SLEEP APNEA (OSA) Patient Care Issuing Authority Dr. James Flynn, Clinical Chief Surgical Services (Perioperative) Signed
PHYSIOTHERAPY IN INTENSIVE CARE: how the evidence has changed since 2000 Kathy Stiller Physiotherapy Department Royal Adelaide Hospital Adelaide South Australia Kathy.Stiller@health.sa.gov.au Aim review
PEDIATRIC PAP TITRATION PROTOCOL
PURPOSE In order to provide the highest quality care for our patients, our sleep disorders facility adheres to the AASM Standards of Accreditation. The accompanying policy and procedure on pediatric titrations
Preventing Respiratory Complications of Muscular Dystrophy
Preventing Respiratory Complications of Muscular Dystrophy Jonathan D. Finder, MD Professor of Pediatrics University of Pittsburgh School of Medicine Children s Hospital of Pittsburgh Introduction Respiratory
Foundations of Critical Care Nursing Course. Tracheostomy Workbook
Foundations of Critical Care Nursing Course Tracheostomy Workbook 1 Key Reference: Dawson D (2014) Essential principles:trachepstomy care in the adult patient, Nursing in Critical Care, Vol 19, 2 p.63-72.
Objectives. Health care significance of ARF 9/10/15 TREATMENT OF ACUTE RESPIRATORY FAILURE OF VARIABLE CAUSES: INVASIVE VS. NON- INVASIVE VENTILATION
TREATMENT OF ACUTE RESPIRATORY FAILURE OF VARIABLE CAUSES: INVASIVE VS. NON- INVASIVE VENTILATION Louisa Chika Ikpeama, DNP, CCRN, ACNP-BC Objectives Identify health care significance of acute respiratory
BTS Guidelines for Home Oxygen in Children
ISSN 2040-2023 August 2009 BTS Guidelines for Home Oxygen in Children A Quick Reference Guide British Thoracic Society www.brit-thoracic.org.uk HOME OXYGEN IN CHILDREN BTS GUIDELINES FOR HOME OXYGEN IN
SURGERY OR ANESTHESIA
Common Formats Aggregate Report Hospital SURGERY OR ANESTHESIA DEFINITION OF EVENT EVENTS INCLUSIONS Event type Incidents 823 174 257 225 167 Harm 735 154 228 205 148 No harm 88 20 29 20 19 Can t tell
SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY
PS1070 SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY TITLE: ADMISSION/DISCHARGE CRITERIA: CARDIOVASCULAR INTENSIVE Job Title of Reviewer: Director, CVICU EFFECTIVE DATE: REVIEWED/REVISED DATE: POLICY
NIV - BI-LEVEL POSITIVE AIRWAY PRESSURE (BIPAP)
Introduction NIV - BI-LEVEL POSITIVE AIRWAY PRESSURE (BIPAP) Noninvasive ventilation (NIV) is a method of delivering oxygen by positive pressure mask that allows for the prevention or postponement of invasive
1.40 Prevention of Nosocomial Pneumonia
1.40 Prevention of Nosocomial Pneumonia Purpose Audience Policy Statement: The guideline is designed to reduce the incidence of pneumonia and other acute lower respiratory tract infections. All UTMB healthcare
Exclusion Criteria 1. Operator or supervisor feels specific intra- procedural laryngoscopy device will be required.
FELLOW Study Data Analysis Plan Direct Laryngoscopy vs Video Laryngoscopy Background Respiratory failure requiring endotracheal intubation occurs in as many as 40% of critically ill patients. Procedural
Understanding Breathing Muscle Weakness
Understanding Breathing Muscle Weakness A N D R E A L. K L E I N P R E S I D E N T / F O U N D E R B R E A T H E W I T H M D w w w.facebook.com/ b r e a t h e w i t h m d h t t p : / / w w w. b r e a t
Neonatal/Pediatric Specialty Examination Detailed Content Outline
I. COMPETENCIES SHARED BETWEEN CRITICAL AND GENERAL CARE 10 32 17 59 A. Assess Patient Information 1 5 7 13 1. Patient history, for example, immunizations environmental pre-existing conditions 2. Physical
Mechanical Ventilation Principles and Practices
Mechanical Ventilation Principles and Practices Dr LAU Chun Wing Arthur Department of Intensive Care Pamela Youde Nethersole Eastern Hospital 6 October 2009 In this lecture, you will learn Major concepts
Specific Basic Standards for Osteopathic Fellowship Training in Pulmonary / Critical Care Medicine
Specific Basic Standards for Osteopathic Fellowship Training in Pulmonary / Critical Care Medicine American Osteopathic Association and American College of Osteopathic Internists BOT Rev. 2/2011 These
SCOTTISH MUSCLE NETWORK DUCHENNE MUSCULAR DYSTROPHY TRANSITION SOME USEFUL THINGS TO KNOW ABOUT HEALTH AROUND ADOLESCENCE
SCOTTISH MUSCLE NETWORK DUCHENNE MUSCULAR DYSTROPHY TRANSITION SOME USEFUL THINGS TO KNOW ABOUT HEALTH AROUND ADOLESCENCE 02 Changes in our lives can be stressful and leaving school and moving into the
Do Not Cite. For Public Comment Period DRAFT MEASURE #3: Evaluation of Pulmonary Status Ordered MUSCULAR DYSTROPHY
MEASURE #3: Evaluation of Pulmonary Status Ordered MUSCULAR DYSTROPHY Measure Description All patients diagnosed with a muscular dystrophy who had a pulmonary status evaluation* ordered. Measure Components
Asthma Coding Fact Sheet for Primary Care Pediatricians
01/01/2017 Asthma Coding Fact Sheet for Primary Care Pediatricians Physician Evaluation & Management Services Outpatient 99201 99202 99203 99204 99205 Office or other outpatient visit, new patient; self
Alternative title: Confessions of a Mucus Enthusiast. Mechanical Insufflation Exsufflation for airway secretion clearance and lung expansion therapy
Mechanical Insufflation Exsufflation for airway secretion clearance and lung expansion therapy Alternative title: Confessions of a Mucus Enthusiast Marty Davig, RRT RCP Philips Respironics Inc. Objectives
Pain & Sedation Management in PICU. Marut Chantra, M.D.
Pain & Sedation Management in PICU Marut Chantra, M.D. Pain Diseases Trauma Procedures Rogers Textbook of Pediatric Intensive Care, 5 th ed, 2015 Emotional Distress Separation from parents Unfamiliar
Non-Invasive Ventilation
Khusrav Bajan Head Emergency Medicine, Consultant Intensivist & Physician, P.D. Hinduja National Hospital & M.R.C. 112 And the Lord God formed man of the dust of the ground and breathed into his nostrils
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
Noninvasive ventilation: Selection of patient, interfaces, initiation and weaning
CME article Johnson S, et al: Noninvasive ventilation Noninvasive ventilation: Selection of patient, interfaces, initiation and weaning Saumy Johnson, Ramesh Unnikrishnan * Email: ramesh.unnikrishnan@manipal.edu
RESPIRATORY COMPLICATIONS AFTER SCI
SHEPHERD.ORG RESPIRATORY COMPLICATIONS AFTER SCI NORMA I RIVERA, RRT, RCP RESPIRATORY EDUCATOR SHEPHERD CENTER 2020 Peachtree Road, NW, Atlanta, GA 30309-1465 404-352-2020 DISCLOSURE STATEMENT I have no
Acute NIV in COPD and what happens next. Dr Rachael Evans PhD Associate Professor, Respiratory Medicine, Glenfield Hospital
Acute NIV in COPD and what happens next Dr Rachael Evans PhD Associate Professor, Respiratory Medicine, Glenfield Hospital Content Scenarios Evidence based medicine for the first 24 hrs Who should we refer
Proportional Assist Ventilation (PAV) (NAVA) Younes ARRD 1992;145:114. Ventilator output :Triggering, Cycling Control of flow, rise time and pressure
Conflict of Interest Disclosure Robert M Kacmarek Unconventional Techniques Using Your ICU Ventilator!" 5-5-17 FOCUS Bob Kacmarek PhD, RRT Massachusetts General Hospital, Harvard Medical School, Boston,
Condensed version.
I m Stu 3 Condensed version smcvicar@uwhealth.org Listen 1. Snoring 2. Gurgling 3. Hoarseness 4. Stridor (inspiratory/expiratory) 5. Wheezing 6. Grunting Listen Crackles Wheezing Stridor Absent Crackles
Average volume-assured pressure support
Focused review Average volume-assured pressure support Abdurahim Aloud MD Abstract Average volume-assured pressure support (AVAPS) is a relatively new mode of noninvasive positive pressure ventilation
Optimize vent weaning and SBT outcomes. Identify underlying causes for SBT failures. Role SBT and weaning protocol have in respiratory care
Optimize vent weaning and SBT outcomes Identify underlying causes for SBT failures Role SBT and weaning protocol have in respiratory care Lower risk of developing complications Lower risk of VAP, other
Credential Maintenance Program
First Quarter of the Calendar 5 I. COMPETENCIES SHARED BETWEEN CRITICAL AND GENERAL CARE 3 7 0 A. Assess Patient Information 0 2 2. Patient history, for example, immunizations environmental pre-existing
Carole Wegner RN, MSN And Lori Leiser CRT
Airway Clearance Carole Wegner RN, MSN And Lori Leiser CRT Topics Suctioning and suctioning equipment Medications to facilitate t airway clearance Bronchial hygiene modalities Preparing for suctioning
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
Reasons Providers Use Bilevel
Reasons Providers Use Bilevel More comfort, improve therapy compliance Noncompliant OSA (NCOSA) 1 Scripts from lab referrals Central/Complex Sleep Apnea 2 For ventilations needs Restrictive Thoracic Disorders/Neuromuscular
TRACHEOSTOMY CARE. Tracheostomy- Surgically created hole that extends from the neck skin into the windpipe or trachea.
1 TRACHEOSTOMY CARE Definitions: Trachea-Windpipe Tracheostomy- Surgically created hole that extends from the neck skin into the windpipe or trachea. Outer Cannula- The outer part of a trach tube. Usually
Sedation Hold/Interruption and Weaning Protocol ( Wake-up and Breathe )
PROTOCOL Sedation Hold/Interruption and Weaning Protocol ( Wake-up and Breathe ) Page 1 of 6 Scope: Population: Outcome: Critical care clinicians and providers. All ICU patients intubated or mechanically
Quando la NIV non basta. Andrea Vianello Fisiopatologia e Terapia Intensiva Respiratoria Ospedale-Università di Padova
Quando la NIV non basta Andrea Vianello Fisiopatologia e Terapia Intensiva Respiratoria Ospedale-Università di Padova Sixty-two RCTs including a total of 5870 patients Overall NIV failure: 16.3% NIV Real
NIV in Acute Respiratory Failure: Where we fail? Dr Shrikanth Srinivasan MD,DNB,FNB,EDIC Consultant, Critical Care Medicine Medanta, The Medicity
NIV in Acute Respiratory Failure: Where we fail? Dr Shrikanth Srinivasan MD,DNB,FNB,EDIC Consultant, Critical Care Medicine Medanta, The Medicity Use of NIV 1998-2010 50 45 40 35 30 25 20 15 10 5 0 1998
Non-invasive Ventilation
Non-invasive Ventilation 163 29 Non-invasive Ventilation AM BHAGWATI Artificial ventilatory support has became an integral component in the management of critically ill patients in the intensive care units.
Tracheostomy and laryngectomy airway emergencies: an overview for medical and nursing staff
2013 Medical Journal Tracheostomy and laryngectomy airway emergencies: an overview for medical and nursing staff Steven Lobaz 1 and Paul Bush 2 1 ST6 and 2 Consultant Department of Anaesthesia and Intensive
Acute noninvasive ventilation what s the evidence? Respiratory Medicine Update: Royal College of Physicians & BTS Thu 28 th January 2016
Acute noninvasive ventilation what s the evidence? Respiratory Medicine Update: Royal College of Physicians & BTS Thu 28 th January 2016 Annabel Nickol Consultant in Respiratory Medicine, Sleep & Ventilation
Supplementary Online Content 2
Supplementary Online Content 2 van Meenen DMP, van der Hoeven SM, Binnekade JM, et al. Effect of on demand vs routine nebulization of acetylcysteine with salbutamol on ventilator-free days in intensive
Dr Alireza Yarahmadi and Dr Arvind Perathur Mercy Medical Center - Winter Retreat Des Moines February 2012
Dr Alireza Yarahmadi and Dr Arvind Perathur Mercy Medical Center - Winter Retreat Des Moines February 2012 Why screen of OSA prior to surgery? What factors increase the risk? When due to anticipate problems?
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