Ever wonder what the BIS monitor is telling us when a patient is on paralysis protocol? Here’s a great PowerPoint presentation about BIS monitoring from Abbotsford Hospital.
View PPT Slides below:
Browsing Posts tagged paralysis
Assisted Cough
(Quad Cough)By having someone assist you in coughing, your cough will be more forceful and productive and you will be able to both prevent and treat some respiratory complications by bringing up secretions normally present in the lung. Indications for an assisted cough are:
* Weak or ineffective cough, and/or
* Excessive secretionsReasons to avoid an assisted cough are:
* Pain
* Internal problems, such as abdominal complications, where pushing on the abdomen could cause more complications
* Chest injury ( broken ribs)
* Flail chest, where the chest has excessive mobility, usually due to paralysis of the muscles which control it.Method:
Assisted Cough
The Institute for Rehabilitation Research and Development (IRRD)
at The Rehabilitation Centre (Ottawa)
VIEW PDF
Guillain-Barré Syndrome is the leading cause of nontraumatic acute paralysis in industrialized countries. About 30% of patients have RESPIRATORY failure requiring intensive care unit (ICU) admission and invasive mechanical ventilation. Progressive weakness of both the inspiratory and the expiratory muscles is the mechanism leading to respiratory failure. Aspiration pneumonia and atelectasis are common consequences of the bulbar muscle weakness and ineffective cough.
From the Department of Neurology at the Mayo Clinic, there appears to be diagnostic and clinical techniques in deciding when/if a patient requires admission to the I.C.U.
In the study ( from Vol. 58 No. 6, June 2001 Archives of Neurology) 114 patients with GBS who were admitted to the Intensive Care unit were studied.
In summery the results they found were the following:
Those requiring mechanical ventilation were found to have bilateral facial weakness, or dysautonomia, and bulbar dysfunction. Spirometry values indicated concern with VC <20 ml/kg, MIP ,30 cmH20 and a maximum expiratory pressure of <40 cmH20.
