Archive for August, 2009

Copan Flocked SWABS have no internal mattress core to disperse and entrap the precious sample like traditional fiber wound swabs. In stark contrast, the entire sample stays close to the surface for fast and complete elution.

nasohead

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New Ventilation Modes

•Dual Control

Within-a-breath switches from PC to VC during the breath

• VAPS and pressure augmentation

Breath-to-Breath

– Pressure-Limited, Flow-Cycled Ventilation

• Volume support ventilation VSV Siemens 300

• Variable-pressure-support Cardiopulmonary

corporation Venturi,

– Pressure-Limited, Time-Cycled Ventilation

• Pressure-regulated volume-control PRVC Siemens 300

• Adaptive pressure ventilation APV Hamilton Galileo

• Auto-flow Draeger Evita 4

• Volume-control Puritan Bennett 840

• Variable pressure control Cardiopulmonary

corporation Venturi

•Proportional-Assist Ventilation

•Adaptive Support Ventilation

•Automatic Tube Compensation

•Airway Pressure-Release Ventilation

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nmv

Trach Tube Size chart

Below is a reference for tracheostomy tubes and their relative sizes to one another.

Click on image to zoom.

TT sizes

Bles FlowChart

Surfactant Prophylaxis

Surfactant Treatment

bles flowchart

Chest Tubes Refresher

Chest Tubes

1- What are chest tubes used for?

2- Where exactly is a chest placed?

3- How does the three-chamber system work?

4- Can suction be bad for the patient?

5- What is the difference between exudate and transudate, and why do we care?

6- What is an effusion?

7- How are effusions treated?

8- When should a chest tube for effusions be removed?

9- What is pleurodesis?

10-  How are malignant effusions treated?

11- What is streptokinase used for when it is given through a chest tube?

12- What is empyema?

13- What exactly is an air leak?

14- How can you tell if the chest tube port is out of the chest?

15- How can this be fixed?

16- Are air leaks good or bad?

17- Would that be a bad situation?

18- What is the black button on top of the pleurevac for?

19- What is tube “stripping”?

20- How could I tell if a patient were developing a tension situation in her chest?

21- What is a pulsus paradoxus?

22- Should you ever clamp a chest tube?

23- What if the chest tube gets pulled out by mistake?

24- What is “water seal”?

25- What is subcutaneous emphysema, and what does it have to do with chest tubes?

cht

Continue Reading Complete Tutorial in PDF


Neonatal ETT size cheat sheet

neobar2

Gest. Age Weight Tube Size Level Suction Cath. Blade
< 28 wks <1000 gm 2.5 7 cm 5 fr 00
28-34 wks 1000-2000 gm 3.0 8 cm 6 fr 0
35-38 wks 2000-3000 gm 3.5 9 cm 8 fr 1
> 38 wks >3000 gm 4.0 10 cm 8fr 1

Tip to lip distance (6+wt. in kg)  *  Trim OETT at 13cm on an angle


The University Hospital of Alberta in Edmonton is a leading Canadian clinical, research and teaching hospital. The institution was one of the first to implement and utilize NAVA – Neurally Adjusted Ventilatory Assist. Two specialty critical care units have been gaining experience in specific patient categories: the Cardiovascular ICU and the Neuro ICU, and the technology is in line to be implemented at the pediatric and neonatal ICU at Stollery Children’s Hospital within the institution.

navaabltRead Article

1.1 To ensure ventilation and management of a status asthmaticus patient is initiated and maintained according to standard.

Definitions:

  • Permissive hypercapnia or controlled hypoventilation:

A strategy for management of patients requiring mechanical ventilation whereby priority is given to the prevention or limitation of severe pulmonary hyperinflation over the maintenance of normal alveolar ventilation.  This involves allowing arterial CO2 to be as high as 90mmHg, with no particular emphasis on acidosis correction.

  • Effective tidal volume (VTeff):

The exhaled tidal volume minus volume lost to tubing compliance.

  • Minimum alveolar concentration (MAC):

The concentration of an agent in alveolar gas necessary to prevent reflex movement in 50% of patients when a standard surgical incision is made.

  • VILI:

Ventilator induced lung injury.

  • Heliox:

A colorless, odourless, and tasteless inert gas.  It has a lower density and Reynold’s number than Nitrogen, the normal balance gas in air.  The lower Reynold’s number allows it to remain in a state of laminar flow even in very small airways, where air normally tends to switch to turbulent flow.  The laminar flow pattern improves alveolar emptying, and ventilation.

  • Isoflurane:

A volatile agent that is used for general anesthesia but has been shown to dilate the airway through B-adrenergic receptor stimulation.  It has minimal cardiovascular side effects however it can decrease systemic vascular resistance and may cause cerebral vasodilation, with increases in ICP seen in concentrations of > 1.1%.

astma

Read FULL article Below

Status Asthmaticus Ventilation and Management 2.3.4-51

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