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https://www.readbyqxmd.com/read/29707505/acute-airway-management
#1
Nikhil Panda, Dean M Donahue
Acute airway management has challenged clinicians for nearly four millennia. History underscores the discoveries of surgeons and anesthesiologists, whose advances in technology and surgical technique have transformed management algorithms from primarily surgical tracheostomy, to transoral endotracheal intubation under direct laryngoscopy. Despite this progress and a better understanding of airway anatomy, physiology and pathogenesis of disease, the acute airway, whether obstructed, traumatically disrupted, or externally compressed, remains a life-threatening challenge...
March 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29549460/success-rates-of-pre-hospital-difficult-airway-management-a-quality-control-study-evaluating-an-in-hospital-training-program
#2
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported...
March 16, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29525391/an-evidence-based-practical-approach-to-pediatric-otolaryngology-in-the-developing-world
#3
REVIEW
Ryan H Belcher, David W Molter, Steven L Goudy
Despite humanitarian otolaryngology groups traveling in record numbers to resource-limited areas treating pediatric otolaryngology disease processes and training local providers, there remains a large burden of unmet needs. There is a meager amount of published information that comes from the developing world from an otolaryngology standpoint. As would be expected, the little information that does comes involves some of the most common pediatric otolaryngology diseases and surgical burdens including childhood hearing loss, otitis media, adenotonsillectomies, airway obstructions requiring tracheostomies, foreign body aspirations, and craniomaxillofacial surgeries, including cleft lip and palate...
June 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29507719/the-patient-needing-prolonged-mechanical-ventilation-a-narrative-review
#4
REVIEW
Nicolino Ambrosino, Michele Vitacca
Background: Progress in management has improved hospital mortality of patients admitted to the intensive care units, but also the prevalence of those patients needing weaning from prolonged mechanical ventilation, and of ventilator assisted individuals. The result is a number of difficult clinical and organizational problems for patients, caregivers and health services, as well as high human and financial resources consumption, despite poor long-term outcomes. An effort should be made to improve the management of these patients...
2018: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/29446694/experimental-measurement-of-forces-during-percutaneous-dilatational-tracheostomy
#5
Silvia Pancani, Antonio Virga, Rosario Spina, Adriano Peris, Andrea Corvi
The measurement of mechanical effects associated with the dilatation phase of a percutaneous dilatational tracheostomy is of primary importance to identify the causes of major complications associated with this procedure, such as tracheal cartilage subluxation or fracture and bleeding. Such information can be very useful also for the design of better instruments and procedures. The aim of this study was to present a methodology to evaluate mechanical effects of the dilatation phase of a percutaneous dilatational tracheostomy on the tracheal rings and adjacent anatomical structures...
April 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/29326127/skill-sets-required-for-the-management-of-military-head-face-and-neck-trauma-a-multidisciplinary-consensus-statement
#6
John Breeze, R Blanch, J Baden, A M Monaghan, D Evriviades, S E Harrisson, S Roberts, A Gibson, N MacKenzie, D Baxter, A J Gibbons, S Heppell, J G Combes, R F Rickard
INTRODUCTION: The evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons. METHOD: A systematic review was undertaken to identify those surgical procedures performed to treat acute military head, face, neck and eye trauma...
January 10, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29224825/head-and-neck-free-flap-reconstruction-what-is-the-appropriate-post-operative-level-of-care
#7
Varun V Varadarajan, Hassan Arshad, Peter T Dziegielewski
Patients undergoing head and neck reconstruction require complex, multidisciplinary postoperative care which may include wound care, flap monitoring, tracheostomy management, and management of comorbid conditions. Historically, patients undergoing major resection of a head and neck or aerodigestive tract malignancy with regional or free flap reconstruction were routinely admitted to the ICU. Although head and neck cancer patients may have multiple medical comorbidities that may require postoperative critical care, the current trend in many institutions is to transfer stable and less medically complex patients to non-intensive care-level units with specialty trained nursing staff...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29170352/55-mini-sim-innovative-bite-sized-simulation-teaching-in-a-busy-children-s-emergency-department
#8
Rachel Sunley, Karen Moloney, Jessica Parker, Christopher Arrowsmith, Kirsty Brown, Alex Wilson
: Emergency Medicine requires a highly skilled workforce who are passionate about delivering excellent patient care. Shift patterns linked with the ever increasing numbers of patients who attend Emergency Departments puts strain on educating the workforce and fostering team togetherness.Our objective in devising and instigating the 'Mini Sim' programme was to embed regular in-situ simulation training to enhance the learning of all staff within our Emergency Department team, building a highly trained workforce to deliver excellent care within the remit of our busy department...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29091036/a-prospective-descriptive-study-to-assess-nursing-staff-perceptions-of-and-interventions-to-prevent-medical-device-related-pressure-injury
#9
Ayişe Karadag, Seval C Hanönü, Evrim Eyikara
Nurses play an important role in identifying patients at risk for medical device-related (MDR) pressure injuries and preventing their occurrence. A prospective, descriptive study was conducted across 6 hospitals in Ankara, Turkey between December 2014 and June 2015 to assess nursing perceptions about and interventions used for the pre- vention of MDR pressure ulcers. A questionnaire was used to collect demographic information and data on experience with MDR pressure ulcers; in addition, participants completed a Nursing Interventions Form that included 10 statements regarding basic nursing interventions to prevent MDR pressure ulcers; answer options were I perform, I partly perform, I do not perform...
October 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28984426/caregiver-knowledge-and-skills-to-safely-care-for-pediatric-tracheostomy-ventilation-at-home
#10
Reshma Amin, Chris Parshuram, Jeannie Kelso, Audrey Lim, Dimas Mateos, Ian Mitchell, Hema Patel, Madan Roy, Faiza Syed, Rita Troini, David Wensley, Louise Rose
OBJECTIVE: Caregivers of children using home mechanical ventilation (HMV) via tracheostomy require appropriate knowledge and skills. Existing training curricula are locally developed and content variable. We sought to develop a competency checklist to inform initial training and subsequent assessment of knowledge and skills of family caregivers. METHODS: We used a 2-step process. Candidate items were generated by synthesis of a scoping review, existing checklists, with additional items suggested by an eight member inter-professional group representing pediatric HMV programs across Canada...
December 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28943140/hospital-to-home-a-quality-improvement-initiative-to-implement-high-fidelity-simulation-training-for-caregivers-of-children-requiring-long-term-mechanical-ventilation
#11
Jodi Thrasher, Joyce Baker, Kathleen M Ventre, Sara E Martin, Jessica Dawson, Roberta Cox, Heather M Moore, Sarah Brethouwer, Sharon Sables-Baus, Christopher D Baker
BACKGROUND: Preparing families of children requiring long-term mechanical ventilation (LTMV) to manage medical emergencies at home is challenging. Opportunities for family caregivers to rehearse crisis management in a controlled setting before discharge are limited. OBJECTIVE: We aimed to create a multimodal discharge preparedness curriculum, incorporating high-fidelity simulation training, to prepare family caregivers of children with complex medical conditions requiring long-term mechanical ventilation...
January 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28936545/open-tracheostomy-training-a-nationwide-survey-among-otolaryngology-head-and-neck-surgery-residents
#12
Limor Muallem-Kalmovich, Jacob Pitaro, Ayman Asaly, Alex Kessler, Ephraim Eviatar, Moran Shteiner, Tal Marom
The aim of this study was to examine the training methods and needs of Otolaryngology-Head and Neck Surgery (OTO-HNS) residents to independently perform open tracheostomy (OT). An anonymous 26-items questionnaire pertaining to OT teaching aspects was distributed to all 93 Israeli OTO-HNS residents during March-June 2016. Residents were categorized as 'juniors,' if they were in their post-graduate year (PGY)-1 and PGY-2; 'mid-residency' (PGY-3 and PGY-4); or 'seniors' (PGY-5 and PGY-6). Response rate was 74% (n = 69)...
November 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28756495/percutaneous-dilatational-tracheostomy-using-the-etview-tracheoscopic-ventilation-tube-%C3%A2-a-teaching-course-in-a-pig-model
#13
Alfonso Fiorelli, Fausto Ferraro, Elisabetta Frongillo, Pierluigi Fusco, Matteo Pierdiluca, Francesca Nagar, Angela Iuorio, Mario Santini
OBJECTIVE: We planned a training course for trainees of different specialties with the aim of teaching the skills of a new procedure for performing percutaneous dilatational tracheostomy (PDT) with an ETView tracheoscopic ventilation tube instead of standard bronchoscopy in an ex vivo pig model. METHODS: The endotracheal tube, with a camera-embedded tip, was used as an alternative to standard bronchoscopy for visualization of patient airways. The procedure was performed on a home-made animal model...
October 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28688550/a-quality-study-of-family-centered-care-coordination-to-improve-care-for-children-undergoing-tracheostomy-and-the-quality-of-life-for-their-caregivers
#14
Christopher Hartnick, Gillian Diercks, Vanessa De Guzman, Elizabeth Hartnick, Jeanne Van Cleave, Kevin Callans
IMPORTANCE: Approximately 4000 U.S. children undergo tracheostomy yearly [1], and these surgeries often result in hospital re-admissions that have definite cost and caregiver burdens due to complications that are avoidable with proper training and support. OBJECTIVE: To assess the impact of a Family-Centered Care Coordination (FCCC) program on the quality of care received by children undergoing tracheostomy and their caregivers. DESIGN: Caregivers of children undergoing tracheostomies from January 2012 to January 2013 and then a different set of caregivers of children undergoing tracheostomies from January 2015 to January 2016 completed both the Pediatric Tracheostomy Health Status Instrument (PTHSI) 1 month after discharge and the Medical Complications Associated with Pediatric Tracheostomy (MCAT) questionnaire 6 months after initial tracheostomy...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28635221/-treatment-of-intractable-aspiration-after-partial-laryngectomy-by-cuffed-tracheostomy-tube-with-inner-cannula
#15
P Wang, Y H Liu, Q S Xu, Z S Zheng
Objective: To evaluate the efficacy of cuffed tracheostomy tube with inner cannula for the treatment of intractable aspiration after partial laryngectomy. Methods: From May 2010 to June 2015, 15 patients with intractable aspiration after partial laryngectomy of laryngeal and hypopharyngeal carcinoma were enrolled. Cuffed tracheostomy tube with inner cannula was used in the 15 patients for treatment of intractable aspiration. The patients and their family were trained to manage the cuffed tracheostomy tube with inner cannula and to eat since the 14th day after surgery...
June 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28616369/management-of-an-obstructed-tracheostomy-in-a-limited-resource-setting
#16
Julie Chiaravalli, Norman Lufesi, Elwin Shawa, Vitumbiko Nkhoma, Elaine Sigalet, Adam Dubrowski
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi...
May 13, 2017: Curēus
https://www.readbyqxmd.com/read/28502311/tracheotomy-related-deaths
#17
Eckart Klemm, Andreas Karl Nowak
BACKGROUND: Tracheotomies are frequently performed on ventilated patients in intensive care and sometimes lead to fatal complications. In this article, we discuss the causes and frequency of death associated with open surgical tracheotomy (OST) and percutaneous dilatational tracheotomy (PDT) on the basis of a review of the pertinent literature. METHODS: We systematically searched the PubMed, EMBASE, and Cochrane Library databases and the Karlsruhe Virtual Catalog for publications (1990-2015) on tracheotomy-related deaths in adults, using the search terms "tracheotomy" and "tracheostomy...
April 21, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28484927/ethical-and-legal-considerations-in-the-management-of-an-unbefriended-patient-in-a-vegetative-state
#18
Alexandra Lloyd-Smith Sequeira, Ariane Lewis
BACKGROUND: Patients without surrogates are referred to as "unbefriended." Because these patients do not have representatives to assist with medical decision-making, patient autonomy and self-determination, fundamental concepts of American healthcare, are jeopardized. METHODS: We present a case of an unbefriended patient in a vegetative state and discuss the ethical and legal complications associated with management of unbefriended patients. RESULTS: An unbefriended patient was admitted to our hospital with a cardiac arrest in the setting of an intracerebral hemorrhage...
October 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28468263/an-evaluation-of-a-continuing-education-program-for-family-caregivers-of-ventilator-dependent-children-with-spinal-muscular-atrophy-sma
#19
Deborah S Boroughs
Until 25 years ago, there were limited options for long-term mechanical ventilation of children, and the majority of children were cared for in hospitals. However, with improving technology, the pediatric intensive care unit has moved from the hospital to a home setting, as children with increasingly complex healthcare needs are now often cared for by family members. One of the most complex care conditions involves ventilator and tracheostomy support. Advanced respiratory technologies that augment natural respiratory function prolong the lives of children with respiratory compromise; however, this care often comes with serious risks, including respiratory muscle impairment, respiratory failure, and chronic pulmonary disease...
April 29, 2017: Children
https://www.readbyqxmd.com/read/28463637/declining-otolaryngology-resident-training-experience-in-tracheostomies-case-log-trends-from-2005-to-2015
#20
David Lesko, Jason Showmaker, Ceisha Ukatu, Qiwei Wu, C W David Chang
Objective To evaluate recent tracheostomy surgical experience among otolaryngology residents and general surgery residents. Study Design Retrospective database review. Setting Accreditation Council for Graduate Medical Education otolaryngology and general surgery programs. Subjects and Methods Accreditation Council for Graduate Medical Education case log data from 2005 to 2015 for resident graduates in otolaryngology and general surgery were used to obtain mean graduate tracheostomy numbers, mean graduate composite case numbers, and number of graduating residents...
June 2017: Otolaryngology—Head and Neck Surgery
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