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5 episodes with extubation
3 episodes with extubation
3 episodes with extubation
3 episodes with extubation
4 episodes with extubation
2 episodes with extubation
2 episodes with extubation
2 episodes with extubation
2 episodes with extubation
In this episode of the PFC Podcast, Dennis and Kevin discuss the intricacies of waking patients after sedation, focusing on procedural sedation techniques, managing emergence delirium, and the challenges of airway management. They share insights from real-world experiences, particularly in combat and austere environments, emphasizing the importance of monitoring and patient safety during the awakening process. The conversation also covers extubation strategies, the differences between Cric and ET tube management, and the significance of having a well-thought-out emergence plan from the start of anesthesia.TakeawaysWaking a patient requires careful monitoring and reorientation.Emergence delirium can occur with ketamine; vigilance is key.Communication with the patient is crucial during awakening.Airway management is critical, especially in trauma cases.TIVA can complicate the emergence process; planning is essential.Extubation should be based on patient readiness and safety.Cric tubes may be better tolerated than ET tubes.Ventilation support may be necessary during the emergence phase.Understanding the patient's history aids in sedation decisions.Always be prepared for unexpected airway challenges.Chapters00:00 Introduction to Patient Awakening01:16 Procedural Sedation Techniques06:24 Managing Emergence Delirium10:40 Airway Management in Sedation15:27 Waking Up After Long Procedures24:23 Extubation Strategies and Considerations30:29 Cric vs. ET Tube Management39:06 Ventilation and Monitoring During EmergenceThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
Send us a textHigher versus lower nasal continuous positive airway pressure for extubation of extremely preterm infants in Australia (ÉCLAT): a multicentre, randomised, superiority trial.Kidman AM, Manley BJ, Boland RA, Malhotra A, Donath SM, Beker F, Davis PG, Bhatia R.Lancet Child Adolesc Health. 2023 Dec;7(12):844-851. doi: 10.1016/S2352-4642(23)00235-3. Epub 2023 Oct 27.PMID: 38240784 Clinical Trial.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode991. In this episode, I’ll discuss what dose of steroids can prevent post-extubation stridor. The post 991: What Dose of Steroids Prevents Post-Extubation Stridor and Re-Intubation? appeared first on Pharmacy Joe.
Send us a textElective extubation during skin-to-skin care in preterm newborns is safe and well-tolerated.Morey-Olivé M, Romaní-Franquesa N, Echeverría-Gallart M, Céspedes-Dominguez MC, Camba-Longueira F, Montaner-Ramon A.Acta Paediatr. 2024 Nov 12. doi: 10.1111/apa.17496. Online ahead of print.PMID: 39530316As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
Send us a textIn this episode, Ben and Daphna are joined by Dr. Risha Bhatia, director of neonatal services at the Royal Women's Hospital in Melbourne, Australia, to discuss the ECLAT trial. This groundbreaking study explores extubation success in extremely preterm infants by comparing CPAP levels of 7 versus 10 cm H₂O. Dr. Bhatia shares insights into the challenges of extubation, the importance of individualized care, and the implications of trial findings for clinical practice. This conversation sheds light on the intricacies of neonatal respiratory management and future research opportunities.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
In this emotional and heartfelt episode, Dr. Stanton Hom and Hope Schachter, a former marriage and family therapist and holistic nutritionist, discuss the harrowing experience of Hope's daughter, Autumn, who became a victim of medical kidnapping during the COVID era. Hope shares the distressing journey from urgent care visits to a forced five-week hospitalization at Stanford's Lucille Packard Children's Hospital, despite constant resistance, misdiagnoses, and aggressive medical interventions. The episode underscores the importance of informed consent, parental rights, and vigilance against medical overreach, while also delving into the complexities of trauma-informed care, medical tyranny, economic ties to healthcare decisions, and the emotional turmoil families face in navigating the healthcare system. Timestamps: 00:00 Introduction to the Future Generations Podcast 01:34 Hope's Background and Autumn's Story Begins 04:36 Autumn's Medical Journey: Initial Symptoms and Urgent Care Visits 07:51 Emergency Room Visit and Diagnosis 09:06 Transfer to Lucille Packard and Initial Treatments 12:29 Challenges and Hostility at Lucille Packard 13:44 Autumn's Decline and Parental Concerns 19:51 Kidney Failure and Dialysis Decisions 23:02 Medical Mismanagement and Parental Advocacy 35:34 CPS Involvement and Legal Battles 42:30 The Terrifying Reality of Medical Collusion 43:50 Autumn's Struggle with Ventilation and Extubation 47:19 The Battle for Autumn's Nutritional Needs 49:39 The Fight to Bring Autumn Home 53:21 The Aftermath and Continued Struggles 56:38 The Importance of Advocacy and Support 01:03:47 The Broader Implications of Medical Kidnapping 01:20:35 Final Thoughts and Future Conversations Resources: Remember to Rate, Review, and Subscribe on iTunes and Follow us on Spotify! Support the Schachter Family: GoFundMe: https://www.gofundme.com/f/help-save-autumn-4 Learn more about Dr. Stanton Hom on: Instagram: https://www.instagram.com/drstantonhom Website: https://futuregenerationssd.com/ Podcast Website: https://thefuturegen.com Twitter: https://twitter.com/drstantonhom LinkedIn: https://www.linkedin.com/in/stanhomdc Stay Connected with the Future Generations Podcast: Instagram: https://www.instagram.com/futuregenpodcast https://www.instagram.com/thefuturegensd https://www.instagram.com/drstantonhom Facebook: https://www.facebook.com/futuregenpodcast/ https://www.facebook.com/thefuturegensd/ If you would like to learn more about the truth behind the pandemic, please check out The End of C0V1D. Click the link to sign up: https://theendofcovid.com/ref/352/ Get the Heart of Freedom III Replay here: https://hof3replay.thefuturegen.com/hof3recording Join the Future Generations Community here: https://community.thefuturegen.com San Diego area residents, take advantage of our special New Patient offer exclusively for podcast listeners here. We can't wait to experience miracles with you! The desire to go off grid and have the ability to grow your own food has never been stronger than before. No matter the size of your property, Food Forest Abundance can help you design a regenerative layout that utilizes your resources in the most synergistic and sustainable manner. If you are interested in breaking free from the system, please visit www.foodforestabundance.com and use code “thefuturegen” to receive a discount on their incredible services. Show your eyes some love with a pair of daylight or sunset (or both!) blue-light blocking glasses from Ra Optics. They have graciously offered Future Generations podcast listeners 10% off any purchase. Use code FGPOD or click here to access this discount, and let us know how your glasses are treating you! Are you a fan of cold plunges? Did you know you can get your hands on a PORTABLE ice bath? Check out the Edge Theory Labs website to learn more about the benefits of cold plunges. Future Generations podcast listeners can enjoy $150 off any tub by using code THEFUTUREGEN. Happy plunging! One of the single best companies whose clean products have supported the optimal wellness of our family is Earthley Wellness. Long before there was a 2020, Kate Tetje and her team have stood for TRUTH, HEALTH and FREEDOM in ways that paved the way for so many of us. In collaboration with this incredible team, we are proud to offer you 10% off of your first purchase by shopping here. Are you concerned about food supply insecurity? 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After extubation, patients are at high risk for silent aspiration (Brodsky et al., 2017; Marvin et al., 2018; McIntyre et al., 2021; Scheel et al., 2015). However, a swallow study is not always practical or possible. The SLP is responsible for determining when one is needed and if oral (PO) intake can be started without […] The post ICU Extubation Protocol appeared first on The MedSLP Collective Podcast.
Episode 35! In this episode we talk about extubation practices with "Effect of aggressive vs conservative screening and confirmatory test on time to extubation among patients at low or intermediate risk: a randomized clinical trial" published in Intensive Care Medicine by Hernandez et al. We then talk about an observation study by Zarrabian et al published in the Blue Journal "Liberation from Invasive Mechanical Ventilation with Continued Receipt of Vasopressor Infusions".SPEED UP: https://pubmed.ncbi.nlm.nih.gov/38353714/Extubation on Pressors: https://pubmed.ncbi.nlm.nih.gov/35107416/If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!
About one in ten live births around the world are preterm and many of these babies will develop respiratory distress and require help with their breathing. Various strategies are available for this and an updated Cochrane review from July 2023 provides the latest evidence on the comparison of nasal intermittent positive pressure ventilation versus nasal continuous positive airway pressure when a baby's breathing tube is removed. We asked one of the authors, Marc-Olivier Deguise from the Children's Hospital of Eastern Ontario in Canada to tell us about the findings, and he used ElevenLabs to make this recording.
About one in ten live births around the world are preterm and many of these babies will develop respiratory distress and require help with their breathing. Various strategies are available for this and an updated Cochrane review from July 2023 provides the latest evidence on the comparison of nasal intermittent positive pressure ventilation versus nasal continuous positive airway pressure when a baby's breathing tube is removed. We asked one of the authors, Marc-Olivier Deguise from the Children's Hospital of Eastern Ontario in Canada to tell us about the findings, and he used ElevenLabs to make this recording.
Unplanned extubation in the PCICU patient is a serious concern with many untoward associations. Who is at highest risk for this complication? Why is this complication associated with worse outcomes in general? How does race or ethnicity impact the likelihood of this complication? We speak with Assistant Professor of Pediatrics at the University of Cincinnati and pediatric cardiac critical care expert, Dr. Tanya Perry about a recent PC4 registry study on unplanned extubation in the PCICU. doi: https://doi.org/10.1097/pcc.0000000000003235
FREE! CRNA School Interview Prep Guide: https://www.cspaedu.com/uc9a5ih4In this third episode with our guest host David Warren, he explores post-extubation emergencies that would require your attention. Tune in as he discusses laryngospasm, the most common emergency you will encounter after such a procedure. David presents several ways to address it as quickly as you can. He also talks about treating post-extubation obstructions and the importance of ensuring that the patient is breathing properly before moving them to PACU.Have you gained acceptance to CRNA school? Congratulations! Prepare with the #1 pre-anesthesia curriculum, as recommended by CRNA program faculty. Start the NAR Boot Camp today: https://www.cspaedu.com/bootcamp Get access to planning tools, mock interviews, valuable CRNA Faculty guidance, and mapped-out courses that have been proven to accelerate your CRNA success! Become a member of CRNA School Prep Academy: https://www.crnaschoolprepacademy.com/join Book a mock interview, personal statement, resume and more at https://www.TeachRN.com Join the CSPA email list: https://www.cspaedu.com/podcast-email
FREE! CRNA School Interview Prep Guide: https://www.cspaedu.com/uc9a5ih4In this special episode, our guest host David Warren continues his discussion about waking someone up from anesthesia. After explaining deep extubation, which is only applicable for a certain population, he now explores the process of awake extubation. Listen as David breaks down this method that many practitioners are typically used to in most ICU situations. He talks about the two primary methods in performing awake extubation: Nitrous Wake-Up and the Propofol Wake-Up.Have you gained acceptance to CRNA school? Congratulations! Prepare with the #1 pre-anesthesia curriculum, as recommended by CRNA program faculty. Start the NAR Boot Camp today: https://www.cspaedu.com/bootcampGet access to planning tools, mock interviews, valuable CRNA Faculty guidance, and mapped-out courses that have been proven to accelerate your CRNA success! Become a member of CRNA School Prep Academy: https://www.crnaschoolprepacademy.com/joinBook a mock interview, personal statement, resume and more at https://www.TeachRN.comJoin the CSPA email list: https://www.cspaedu.com/podcast-email
FREE! CRNA School Interview Prep Guide: https://www.cspaedu.com/uc9a5ih4In this special episode, our guest host David Warren breaks down the basics of doing a deep extubation, one of the two common ways of waking someone up from anesthesia. Tune in as he goes beyond textbook information and discusses the step-by-step process from the day-to-day perspective of a nurse anesthesia resident. David also explains the stages of anesthesia, the hardest part of doing deep extubation, and everything you must take into consideration once the process is done. Have you gained acceptance to CRNA school? Congratulations! Prepare with the #1 pre-anesthesia curriculum, as recommended by CRNA program faculty. Start the NAR Boot Camp today: https://www.cspaedu.com/bootcampGet access to planning tools, mock interviews, valuable CRNA Faculty guidance, and mapped-out courses that have been proven to accelerate your CRNA success! Become a member of CRNA School Prep Academy: https://www.crnaschoolprepacademy.com/join Book a mock interview, personal statement, resume and more at https://www.TeachRN.comJoin the CSPA email list: https://www.cspaedu.com/podcast-email
For many decades the tenet that all children should be extubated awake had prevailed in paediatric anaesthesia. Nowadays, it is understood that the field is rather complex. In this episode, our Host, Dr Markus Stevens, will challenge the dogma of awake extubation in an in-depth discussion with Prof. Britta Regli-von Ungern-Sternberg. Listen and find out more!
Dr. Yurasek is a graduate of the Columbia University College of Physicians and Surgeons. He completed his pediatric residency at Children's Hospital of Boston followed by a pediatric cardiology fellowship also at Boston Children's and a PICU fellowship at Massachusetts General Hospital. He is now a CICU attending and the director of critical care simulation at Children's National Hospital in Washington, DC. How to support PedsCrit:Please rate and review on Spotify or Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Objectives for this series:1. Understand the physiologic considerations that influence preoperative care in the cardiac intensive care unit (CICU).2. Recall the goals and general steps of operative repair.3. Recognize the key information provided in post-op handoff that will affect management.4. Recognize important postoperative complications and develop an approach to their management.5. Develop a mental framework of the expected postoperative CICU course with a focus on barriers to ICU discharge.Support the showSupport the show
Listener Feedback SurveyLearning Objectives:After listening to this episode, learners should be able to:Explain the key milestones that a patient needs to reach before they are a candidate for extubation while on VV-ECMO.Contrast the mobilization best practices for infants vs school-aged children on VV-ECMO.Describe the long-term neurologic effects of a VV-ECMO run, both in infancy and as a school-aged child.About our guests:Jenna Miller, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. She completed her medical school and residency in Kansas City before moving to Texas Children's for critical care fellowship. She is the director of the pediatric ECMO program and the pediatric critical care medicine fellowship at Children's Mercy Kansas City. Her professional and research interests include trimethoprim-sulfamethoxazole ARDS, ECMO and medical education.Dr John Daniel, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. He completed his pediatric residency at the University of South Carolina and his neonatology fellowship at the University of Kentucky. He now is a practicing Neonatal Cardiac Intensivist and the director of the neonatal ECMO program at Children's Mercy Kansas City. ECMO Patient Stories from Children's Mercy Kansas City:https://www.cnn.com/2018/03/21/health/teen-walks-on-life-support-exclusive-profilehttps://www.thedailybeast.com/trevor-hensley-endured-73-days-of-ecmo-to-survive-covidhttps://news.childrensmercy.org/mcpherson-news-ledger-mcpherson-boy-home-following-100-day-hospital-stay/References:Maclare, Graeme, et al. Extracorporeal Life Support: The ELSO Red Book. 6th Edition. Pelosi, er al. Close down the lungs + keep them resting to minimize ventilator induced lung injury. Maharaj et al, Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019Nirmal S Sharma et al. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation. Rosner EA et al. Flexible Bronchoscopy in Pediatric Venovenous Extracorporeal Membrane Oxygenation. Gurnani et al. Outcomes of Extubated COVID and Non-COVID Patients Receiving Awake Venovenous Extracorporeal Membrane Oxygenation, Kohne et al. Tracheostomy Practices and Outcomes in Children During Respiratory Extracorporeal Membrane OxygenationPalen P et al. tracheostomy and long-term mechanical ventilation in children after veno-venous extracorporeal membrane oxygenation.LaRosa JM, Nelliot A, Zaidi M, Vaidya D, Awojoodu R, Kudchadkar SR. Mobilization Safety of Critically Ill Children. Pediatrics. Support the showSupport the show
Lisa Grape gör IVA-juntan större, bättre och vassare - igen! Kontakt: ivajuntan@gmail.com Musik: Blind Love Dub by Jeris (c) copyright 2017 Licensed under a Creative Commons Attribution (3.0) license. http://dig.ccmixter.org/files/VJ_Memes/55416 Ft: Kara Square (mindmapthat) Om du gillar du det vi gör - stöd Life Support Foundation! www.lifesupportfoundation.org Bli månadsgivare eller används Swish: 1234610804 Länk till NAP 4 See omnystudio.com/listener for privacy information.
Lisa Grape gör IVA-juntan större, bättre och vassare - igen! Kontakt: ivajuntan@gmail.com Musik: Blind Love Dub by Jeris (c) copyright 2017 Licensed under a Creative Commons Attribution (3.0) license. http://dig.ccmixter.org/files/VJ_Memes/55416 Ft: Kara Square (mindmapthat) Om du gillar du det vi gör - stöd Life Support Foundation! www.lifesupportfoundation.org Bli månadsgivare eller används Swish: 1234610804 Länk till NAP 4 See omnystudio.com/listener for privacy information.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode791. In this episode, I’ll discuss what dose of steroids can prevent post-extubation stridor. The post 791: What dose of steroids can prevent post-extubation stridor and re-intubation appeared first on Pharmacy Joe.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode791. In this episode, I’ll discuss what dose of steroids can prevent post-extubation stridor. The post 791: What dose of steroids can prevent post-extubation stridor and re-intubation appeared first on Pharmacy Joe.
Paper discussed in today's episode:High-Flow Versus VenturiMask Oxygen Therapy to Prevent Re-Intubation in Hypoxemic Patients After Extubation: A Multicenter, Randomized Clinical Trial
As always, feel free to send us questions, comments or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through instagram or twitter, @nicupodcast. Or contact Ben and Daphna directly via their twitter profiles: @drnicu and @doctordaphnamd. Papers discussed in today's episode are listed and timestamped below.enjoy!_____________________________________________________________________________________Show notes, articles, and CME form can be found on our website: http://www.the-incubator.org/089-jc/
Meet Mr. Silberman JD from the BENESCH law firm! We talk about the New Hampshire ruling and Nurse Anesthesiologist, Qui Tam lawsuits and anti-trust, The risk of medicare fraud with medical direction and TEFRA, if Extubation is part of emergence as it related to TEFRA based on the Donegan v. Anesthesia Associates of Kansas City, PC, Liability of surgeons with CRNAs in the ACT or independently and MUCH more! A little about Mark:Mark is an experienced trial lawyer, health care attorney and litigator. His practice focuses on helping health care professionals and businesses navigate the complex and changing landscape of health care with an emphasis on achieving governmental and regulatory compliance.Mark concentrates on managing internal and external health care investigations, False Claims Act cases, white collar criminal defense, all forms of health care litigation, and all aspects of the Illinois Certificate of Need program.Mark handles audit, compliance, investigations and enforcement actions involving HHS-OIG, the Medicare/Medicaid programs, the Illinois Department of Public Health, and Illinois Health Facilities and Services Review Board (Certificate of Need). He advises clients regarding managing and avoiding allegations of health care fraud and health care-related criminal conduct, addressing concerns related to the Anti-Kickback Statute, and pharmacy and pharmaceutical related litigation. He provides counsel and litigation services for physicians, facilities and pharmacies engaged with any federal agency, along with handling Medicare/Medicaid reimbursement issues, False Claims Act/Qui Tam defense, and various health care transactional matters. Mark also served as the outside General Counsel to the American Association of Nurse Anesthetists.More about Mark can be found hereStories and Strategies for Public RelationsCommunication is in every facet of our daily business.Listen on: Apple Podcasts Spotify
As always, feel free to send us questions, comments or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through instagram or twitter, @nicupodcast. Or contact Ben and Daphna directly via their twitter profiles: @drnicu and @doctordaphnamd. Papers discussed in today's episode are listed and timestamped below.enjoy!_____________________________________________________________________________________Show notes, articles, and CME form can be found on our website: http://www.the-incubator.org/084-journal-clubThis episode is sponsored by Chieisi
Steve and Amanda discuss in-home compassionate extubation and the difficulties inherent in managing nontraditional situations.
In this podcast, we discuss the article 'Developing an Extubation strategy for the difficult pediatric airway — Who, when, why, where, and how?'. We hope you enjoy.
Idag handlar det om extubation av patienter på IVA. Mer konst än vetenskap? Referenser: Krinsley JS, Reddy PK, Iqbal A. What is the optimal rate of failed extubation?. Crit Care. 2012;16(1):111. Published 2012 Feb 20. doi:10.1186/cc11185 Krinsley, J., Reddy, P. & Iqbal, A. Case-control study of failed extubation. Crit Care 16, P128 (2012). https://doi.org/10.1186/cc10735
Should we use rapid shallow breathing index (RSBI) in isolation or in conjunction with other parameters to predict extubation success? Show Notes: https://eddyjoemd.com/rsbi/ GoodRx Link: https://goodrx.onelink.me/1153955910/x52sjptq Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom. Citations: Trivedi V, Chaudhuri D, Jinah R, Piticaru J, Agarwal A, Liu K, McArthur E, Sklar MC, Friedrich JO, Rochwerg B, Burns KEA. The Usefulness of the Rapid Shallow Breathing Index in Predicting Successful Extubation: A Systematic Review and Meta-analysis. Chest. 2022 Jan;161(1):97-111. doi: 10.1016/j.chest.2021.06.030. Epub 2021 Jun 26. PMID: 34181953. Ouellette DR. The Decision to Liberate From the Ventilator: More Than Just a Number. Chest. 2022 Jan;161(1):6-7. doi: 10.1016/j.chest.2021.07.016. PMID: 35000708. --- Support this podcast: https://anchor.fm/eddyjoemd/support
Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel. This podcast is an exciting journey towards improved anesthesia patient safety. Join us today as we dive back into the February 2022 APSF Newsletter article to learn about endotracheal tube securement and prevention of unplanned extubation events and related resources to help keep patients safe. We have more exclusive content from one of the authors, Lauren Berkow, MD and you will not want to miss Part 2 of this series.© 2022, The Anesthesia Patient Safety FoundationFor show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/89-unplanned-extubation-events-prevention/
Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel. This podcast is an exciting journey towards improved anesthesia patient safety. Join us today as we dive into the February 2022 APSF Newsletter article to learn about the incidence and risk factors for unplanned extubation events. Spoiler alert: This event places patients at risk for major complications and comes with a high cost burden. Plus, we have exclusive content from one of the authors, Lauren Berkow, MD. © 2022, The Anesthesia Patient Safety FoundationFor show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/88-unplanned-extubation-part-1-incidence-and-risk-factors/
Extubation Readiness with Alyssa Stoner and Gina Patel--Part 3: Cardiovascular and Gastrointestinal Considerations + Practical Tips for ExtubationAbout our guests:Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.How to support PedsCrit?Please share, like, rate and review on Apple Podcasts or Spotify!Donations appreciated @PedsCrit on Venmo or support us by becoming a Patreon. 100% of all funds will go to supporting the show to keep this project going. Objectives for this episode:The participant will be able to describe 3 factors that influence a patient's readiness to extubate. The participant will be able determine the appropriate level of respiratory support to extubate to based on the patient's clinical picture. The participant will be able to develop and execute a patient's extubation References: Best KM, Boullata JI, Curley MA. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model. Pediatr Crit Care Med. 2015;16(2):175-183. doi:10.1097/PCC.0000000000000306Wratney AT, Benjamin DK Jr, Slonim AD, He J, Hamel DS, Cheifetz IM. The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients. Pediatr Crit Care Med. 2008 Sep;9(5):490-6. doi: 10.1097/PCC.0b013e3181849901. PMID: 18679147; PMCID: PMC2782931.Newth CJ, Hotz JC, Khemani RG. Ventilator Liberation in the Pediatric ICU. Respir Care. 2020;65(10):1601-1610. doi:10.4187/respcare.07810Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10(1):1-11. doi:10.1097/PCC.0b013e318193724dVeldhoen, Esther S et al. “Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?.” PloS one vol. 12,2 e0172096. 16 Feb. 2017, doi:10.1371/journal.pone.0172096Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for informational and educational purposes only. It should not be used as a replacement for medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updatesSupport the show
Extubation Readiness with Alyssa Stoner and Gina Patel--Part 2: Upper Airway and Pulmonary ConsiderationsAbout our guests:Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.How to support PedsCrit?Please share, like, rate and review on Apple Podcasts or Spotify!Donations appreciated @PedsCrit on Venmo or support us by becoming a Patreon. 100% of all funds will go to supporting the show to keep this project going. Objectives for this episode:The participant will be able to describe 3 factors that influence a patient's readiness to extubate. The participant will be able determine the appropriate level of respiratory support to extubate to based on the patient's clinical picture. The participant will be able to develop and execute a patient's extubation References: Best KM, Boullata JI, Curley MA. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model. Pediatr Crit Care Med. 2015;16(2):175-183. doi:10.1097/PCC.0000000000000306Wratney AT, Benjamin DK Jr, Slonim AD, He J, Hamel DS, Cheifetz IM. The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients. Pediatr Crit Care Med. 2008 Sep;9(5):490-6. doi: 10.1097/PCC.0b013e3181849901. PMID: 18679147; PMCID: PMC2782931.Newth CJ, Hotz JC, Khemani RG. Ventilator Liberation in the Pediatric ICU. Respir Care. 2020;65(10):1601-1610. doi:10.4187/respcare.07810Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10(1):1-11. doi:10.1097/PCC.0b013e318193724dVeldhoen, Esther S et al. “Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?.” PloS one vol. 12,2 e0172096. 16 Feb. 2017, doi:10.1371/journal.pone.0172096Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for informational and educational purposes only. It should not be used as a replacement for medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updatesSupport the show
Extubation Readiness with Alyssa Stoner and Gina Patel--Part 1: Introduction and Sedation ManagementAbout our guests:Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.How to support PedsCrit?Please share, like, rate and review on Apple Podcasts or Spotify!Donations appreciated @PedsCrit on Venmo or support us by becoming a Patreon. 100% of all funds will go to supporting the show to keep this project going. Objectives for this episode:The participant will be able to describe 3 factors that influence a patient's readiness to extubate. The participant will be able determine the appropriate level of respiratory support to extubate to based on the patient's clinical picture. The participant will be able to develop and execute a patient's extubation References: Best KM, Boullata JI, Curley MA. Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model. Pediatr Crit Care Med. 2015;16(2):175-183. doi:10.1097/PCC.0000000000000306Wratney AT, Benjamin DK Jr, Slonim AD, He J, Hamel DS, Cheifetz IM. The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients. Pediatr Crit Care Med. 2008 Sep;9(5):490-6. doi: 10.1097/PCC.0b013e3181849901. PMID: 18679147; PMCID: PMC2782931.Newth CJ, Hotz JC, Khemani RG. Ventilator Liberation in the Pediatric ICU. Respir Care. 2020;65(10):1601-1610. doi:10.4187/respcare.07810Newth CJ, Venkataraman S, Willson DF, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10(1):1-11. doi:10.1097/PCC.0b013e318193724dVeldhoen, Esther S et al. “Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?.” PloS one vol. 12,2 e0172096. 16 Feb. 2017, doi:10.1371/journal.pone.0172096Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for informational and educational purposes only. It should not be used as a replacement for medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updatesSupport the show
Clinicians use noninvasive respiratory support interventions in the post-extubation period to mitigate the risk of extubation failure. These interventions [noninvasive positive pressure ventilation (NIPPV) and high-flow nasal cannula (HFNC)] have been shown to be efficacious in preventing initial intubation in patients with hypoxemic respiratory failure, but their efficacy in preventing post-extubation respiratory failure and reintubation is less clear. A systematic review and network meta-analysis of randomised controlled trials (RCTs) to evaluate the relative efficacy of conventional oxygen therapy, NIPPV, HFNC, and the strategy of alternating NIPPV and HFNC during the post-extubation period in reducing extubation failure and short-term mortality among critically ill adults, was conducted. We have interviewed Dr Fernando and Dr Rochwerg to explain these study findings. Speakers Shannon FERNANDO. Division of Critical Care, Department of Medicine, University of Ottawa (CA). Bram ROCHWERG. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton (CA) and Department of Medicine, Division of Critical Care, McMaster University, Hamilton (CA). Ahmed ZAHER. Oxford University Hospitals (UK). ESICM Next Committee member.
In this podcast, Riaz Aziz talks to Dr Vikki Mitchell from University College London Hospital (UCLH) about extubation practices. Dr Mitchell co-authored the DAS guidelines on extubation and has extensive experience as an airway anaesthetist. In this podcast, we run through the DAS guidelines and explore various extubation techniques.
CHEST January 2022, Volume 161, Issue 1 Vatsal Trivedi, MD, and Daniel R. Ouellette, MD, join CHEST Podcast Moderator, Dominique Pepper MD, to discuss how well rapid shallow breathing index predicts successful extubation. DOI: https://doi.org/10.1016/j.chest.2021.06.030
In this episode we talk through explaining ICU care to a patient and their family, with a focus on heart attack, HD support (intraortic balloon pump / pressors), sedation, ventilators, and the process of weaning sedation/extubating. Give us feedback or suggestions on instagram (https://www.instagram.com/losvatosmedicos/?hl=en) or at losvatosmedicos@gmail.com! ~ - Bella Ciao (https://www.youtube.com/watch?v=jhgJV0Pg54Y) - Netflix series: Casa de Papel (Money Heist) - Duolingo Spanish Podcast: El Robo (https://open.spotify.com/episode/2SrzPlMTHhkwWiqx9VBUXb?si=l29Uh6D7SqOuBfJh2uJ5qA)
October 2021: Pediatric Tracheal Extubation with Dr. Debnath Chatterjee
Join us in this episode, where Maddi and I discuss previously asked 3 viva scenarios around 3 themes - Malignant hyperthermia, Failed extubation and Pancreatitis.
Welcome to PICU Doc On Call, A Podcast Dedicated to Current and Aspiring Intensivists. I'm Pradip Kamat and I'm Rahul Damania and we are coming to you from Children's Healthcare of Atlanta - Emory University School of Medicine. Welcome to our PICU Mini-Series Episode a 10 month old who is intubated for acute respiratory failure secondary to RSV bronchiolitis. Here's the case: A 10-month-old full-term infant girl old is intubated for acute respiratory failure secondary to RSV bronchiolitis. Patient was brought to the ED by parents on day 3 of her illness with h/o cough, congestion and worsening respiratory distress. She has had increasing WOB and grunting. After assessment in the ED where the patient had a brief trial of HFNC, she was intubated with a 4.0 ETT due to persistent hypoxemia. Pertinently, her viral panel was positive for RSV, and the patient was transferred to the PICU. In the PICU, patient was ventilated using PRVC: Set TV of 90cc (patient is 11KG), PEEP 6, PS 10, and FIO2 40%. Throughout her course, she was mechanically ventilated and sedated for about a week. She required a continuous infusion of rocuronium due to decreased lung compliance and high peak pressures. Patient weaned on her ventilator settings by ICU day 7 and the decision to move towards extubation was made. To summarize key elements from this case, this patient has: 10 month old with acute respiratory failure secondary to RSV infection and with a secondary bacterial infection due to H.Influenza. Had about a six day course on the ventilator requiring sedation and NMB and now we are at the discussion of extubation readiness.Rahul, do you mind summarizing the patient's peri-extubation course? Sure Pradip, so on day 6 of hospitalization our patient was weaned to low mechanical ventilator settings. The chest radiograph, which initially showed evidence of interstitial pneumonitis and atelectasis now improved and the patient had improved secretion burden. The patient was on ceftriaxone throughout the hospital course as her ETT cx with which grew Hemophilus Influenzae. What about the patient's neurological status? The patient was initially on fentanyl, dexmedetomidine and a rocuronium infusion — a day prior to considering extubation, the patient was off of the continuous rocuronium infusion oxygenating and ventilating well. The patient prior to extubation was wide awake and appropriate during the morning sedation holiday. Any other important clinical markers? Yes, the patient's clinical exam including lung exam was reassuring. The patient underwent a pressure support trial PEEP 5, CPAP 10 and had a normal respiratory effort with exhaled of about 5 mL/kg. The RT, however mentioned that the patient did not have a "leak" when performing the leak test. The finally the patient was given a few doses of furosemide for diuresis prior to extubation. Awesome, today's episode we really want to focus on extubation readiness however prior to this discussion, can we take a step back and talk about some red-flag symptoms which led to intubation for this patient? This patient had severe respiratory distress which progressed to failure. The tachypnea, decreased mentation, and grunting were key signs that the patient was progressing to endotracheal intubation. Grunting is important to highlight as this refers to the child generating auto-PEEP to combat the atelectasis present in bronchiolitis. Remember that a child's chest wall has a high compliance and a decreased propensity for outward elastic recoil — this in essence reduces FRC and thus there is a more balance towards the inward recoil of the long (closing capacity). The highly compliant chest wall and the natural inward recoil of the infant lung creates a propensity towards atelectasis and subsequent impairments in breathing. Low FRC can also create increase PVR which can thus imbalance optimal cardiopulmonary interactions. OK let's transition to our topic of discussion by a quick summary: A 10...
In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Jonathan Casey. They discuss Dr. Casey's Blue Journal Publication of protocolized post-extubation respiratory support to prevent re-intubation, as well as the utility of multicenter adaptive platform trials. Dr. Casey is an Assistant Professor at Vanderbilt University Medical Center.
Extubation is a high-risk endeavor in some COVID-19 patients. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Joshua H. Atkins, MD, PhD; Christopher Rassekh, MD; and Ara Chalian, MD, to discuss recognizing risks surrounding extubation in ventilated COVID-19 patients.
Extubation is a high-risk endeavor in some COVID-19 patients. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Joshua H. Atkins, MD, PhD; Christopher Rassekh, MD; and Ara Chalian, MD, to discuss recognizing risks surrounding extubation in ventilated COVID-19 patients.
Lisa Zwirchmayr, BSc MSc, ist Gesundheits- und Krankenpflegeperson im Bereich der Kinder- und Erwachsenenintensivpflege. Sie beendete 2016 das Bachelorstudium Gesundheits- und Krankenpflege und ist seit 2020 Absolventin des Master-Studienganges Angewandte Gesundheitswissenschaften der IMC Fachhochschule Krems. In dieser Podcastfolge geht es um die Schluckaktbeurteilung von Patient*innen nach einer Extubation. Unter anderem wird die Problemstellung anhand eines Fallbeispiels behandelt, sowie die Forschung von Lisa Zwirchmayr BSc MSc vorgestellt. Am Ende der Folge werden Tipps für die Praxis zusammengefasst. Literaturverzeichnis zum Download _____________________________ Pflegenetz Web: www.pflegenetz.at Youtube: Pflegenetz Facebook: facebook.com/pflegenetz Instagram: @pflegenetz Twitter: @pflegenetz
In this episode of “Ask the Experts,” William Rosenblatt, MD, joins us to discuss the “Airway on Demand” video series and answer a few questions about some unique airway management moments he has caught on camera.Rosenblatt is a professor of anesthesiology at Yale New Haven Hospital and the Yale School of Medicine, in Connecticut. He is the president of “Airway on Demand” and a past president of the Society for Airway Management.“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up-close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine. This is the first episode of the series, and new episodes will be published every month. Links from episodeLink to video in question 1: https://www.anesthesiologynews.com/Policy-and-Management/Article/09-20/Airway-on-Demand-Cricopharyngeus-Muscle-Contraction-During-Video-Laryngoscopy/59603Link to video in question 2: https://www.anesthesiologynews.com/Multimedia/Article/07-20/Airway-on-Demand-Oxygen-Insufflation/59061Link to video in question 3: https://www.anesthesiologynews.com/Multimedia/Article/02-20/Airway-on-Demand-Sleep-Apnea-and-a-Snoring-Airway/57338Link to video in question 4: https://www.anesthesiologynews.com/Multimedia/Article/01-21/Airway-on-Demand-Specialized-Intubation-Via-Supraglottic-Airways/62325Watch more “Airway on Demand” videos at https://www.anesthesiologynews.com/MultimediaLink to “Airway on Demand”: https://www.airwayondemand.com/Book recommendation from Dr. Rosenblatt: https://www.timothysnyder.org/books/our-maladyTwitter follow recommendation from Dr. Rosenblatt: https://twitter.com/JohnCSakles?s=20To submit questions for our next guest, Amy Pearson, MD, email us at ANPresents [at] mcmahonmed.com.
In the third installment of our Johns Hopkins series, hosts Dr. Steven Taback and Bill Curtis are joined by Dr. Martin Brodsky, Speech Pathologist, Associate Professor of Physical Medicine and Rehabilitation, and a Fellow of the American Speech-Language-Hearing Association. Dr. Brodsky shares his insight on Speech Pathology in the ICU, dealing with dysphagia (swallowing problems), and physical therapy for vocal cord damage. In this dedicated series, we're showcasing the medical breakthroughs & innovations from one of the world's most preeminent hospitals: Johns Hopkins Medicine. Johns Hopkins Medicine is dedicated to improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care. Timestamps: 2:23 What is dysphagia? 3:00 Why did Dr. Brodsky first start his career in speech pathology? 4:00 What is different if speech pathology from the past and present? 5:16 What do speech pathologist do inside the ICU? 6:30 Communicating to patients during intubation 8:55 Why not use a tracheotomy when intubation poses risks and rehabilitation? 12:40 Is there a risk of vocal cords never returning to full function? 13:47 What can an Intensivist do to minimize the damages caused by intubation? 18:21 What happens when a patient feels they’re having swallowing problems? 21:35 What is actually creating the problem of swallowing in the ICU? 23:58 What sort of circumstances lead to swallowing issues outside the hospital? 26:00 Physical therapy for swallowing 27:40 What should you be watching out for that can indicate a family member may need to seek help with swallowing? ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media Production See omnystudio.com/listener for privacy information.
In this Rapid Rounds, we provide a quick and closer look at the Yang & Tobin index as originally described in the 1991 NEJM paper.
Determining whether or not your intubated and ventilated patient requires ongoing ventilatory support should not be overly complicated. In this episode we review the approach to determining if our mechanically ventilated patients can be safely extubated. In addition to discussing readiness for spontaneous breathing trial (SBT) criteria, we also discuss the potential utility of "weaning" criteria, choice of method of SBT, and considerations when removing the endotracheal tube.
In this episode, Jeffrey Wayland and David H. Wang, MD discuss compassionate extubation. Mr. Jeffrey Wayland is a medical student at the University of Queensland Faculty of Medicine and Dr. David H. Wang, MD is a palliative medicine specialist at Scripps Health.
Presented by Jeffrey Wayland a medical student at the University of Queensland Faculty of Medicine and David H. Wang, MD a palliative medicine specialist at Scripps Health. Intro music by Akashic Records, Key to Success - Discover the Possibility from the album Corporate Presentation - Key to Success, powered by JAMENDO.
Die Extubation bei CoVid19-Patienten ist etwas anders als normalerweise. Wir haben euch unseren Flowchart auch noch einmal vertont. Hier ist der entsprechende Artikel dazu: Extubation COVID Der Beitrag „titriert“ Kochrezept – Extubation CoVid 19 erschien zuerst auf pin-up-docs - don't panic.
Our guest today is Dr. Tiara Calhoun (@tiaraforsyth), an internal medicine resident at the Massachusetts General Hospital. She is an active contributor to FLARE (Fast Literature Assessment and Review), a newsletter that appraises the rapidly evolving literature on SARS-CoV-2. Check FLARE out here: https://www.massgeneral.org/news/coronavirus/treatment-guidance/fast-literature-updates An additional question for our listeners to dive into is the optimal timing of steroid administration. Let us know what you find! Connect with us @DepthAnesthesia on Twitter or email us at depthofanesthesia@gmail.com Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. -- Full references on Episode Webpage. https://us19.campaign-archive.com/?u=ef98149bee3f299584374540a&id=fe09c50f3a
Unser neuer Podcast ist da, Journal Club, Rauchgasinhalation, Extubation bei CoVid, Basics Beatmung, von Willebrand-Syndrom und noch viel mehr! Hört rein
Le Pr Arnaud Thille, qui est PUPH dans le service de MIR du CHU de Poitiers, nous parle son étude concernant la « place de l’oxygénothérapie haut débit dans la prévention de la ré-intubation en post extubation de patients à haut risque de ré-intubation ».Aucun lien d’intérêt déclaré.Sommaire :• Pouvez-vous nous expliquer le contexte scientifique qui a justifié la réalisation de cette étude ?• Pouvez-vous nous décrire la population incluse et les principaux résultats de l’étude ?• Quelles sont d’après-vous les principales limites de cette étude ?• Cette étude doit-elle modifier notre pratique quotidienne, et si oui comment ?Références :Effect of Postextubation High-Flow Nasal Oxygen With Noninvasive Ventilation vs High-Flow Nasal Oxygen Alone on Reintubation Among Patients at High Risk of Extubation FailureThille A, Muller G, Gacouin A, Coudroy R, Decavèle M, Sonneville R, Beloncle F, Girault C, Dangers L, Lautrette A, Cabasson S, Rouzé A, Vivier E, Le Meur A, Ricard JD, Razazi K, Barberet G, Lebert C, Ehrmann S, Sabatier C, Bourenne J, Pradel G, Bailly P, Terzi N, Dellamonica J, Lacave G, Danin PÉ, Nanadoumgar H, Gibelin A, Zanre L, Deye N, Demoule A, Maamar A, Nay MA, Robert R, Ragot S, Frat JPJAMA. 2019 Oct 2;322(15):1465-1475. DOI : doi: 10.1001/jama.2019.14901.
So much of what we do tell our patients can be confusing, misunderstood, or even insulting. Learn expressions, phrases, and words to enhance your rapport with your patients and ease their anxiety. How we present information is significant. Learn ways that are sensitive and understandable.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode443. In this episode, I’ll discuss what dose of steroids can prevent post-extubation stridor. The post 443: What dose of steroids can prevent post-extubation stridor? appeared first on Pharmacy Joe.
Editor's Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the June 11, 2019 issue
I’m back to work after a few weeks holiday; and as I turns out, 2/2 shifts I’ve either worked towards, or have performed an Extubation. Keeping along this train of thought, I thought I’d cover what we look at prior to extubating a patient; the differences between positive and negative pressure ventilation, the different modes we trial, and the procedure of extubation.
In this episode, Dr. Brodsky discusses when to assess or screen for swallowing function post extubation - what has been done in the past, what is going on today, and what should you do tomorrow? Dr. Brodsky describes a life altering incident that has shaped his career, and we also discuss the importance of clinical research, evidence-based medicine, and why it’s called clinical “practice.”Dr. Brodsky is an Associate Professor of Physical Medicine and Rehabilitation at Johns Hopkins University. His peer-reviewed research publications, book chapters, and invited presentations focus on swallowing and swallowing disorders. Dr. Brodsky’s clinical research is funded by the National Institutes of Health, studying the effects of critical illness and critical care medicine on swallowing and the airway and their long-term outcomes. His clinical practice specializes in adult swallowing and communication disorders. Dr. Brodsky is a Fellow of the American Speech-Language-Hearing Association, a member of the ASHA Advisory Council for Speech-Language Pathology, and a member of the Editorial Board for Dysphagia. He is a frequent reviewer for scientific journals and a member of the Dysphagia Research Society and the American Psychological Association.To learn more about the Medical SLP Collective, an exclusive community for Medical SLPs with new peer-reviewed resources, handouts, and videos distributed weekly, monthly ASHA CEU webinars, and a private forum on Facebook, or on the website to get answers to all of your burning clinical questions, check out MedSLPCollective.com Download Ep. 021 Show Notes! This Month’s Featured Affiliates: If you like our work, support us on Patreon for as little as a dollar a month! Previous Next Previous Next
Dr Gonzalo Hernandez (Madrid) discusses his trial examining the use of high flow nasal oxygen post extubation in critically ill patients at the Critical Care Reviews Meeting 2017
Margaret Parker, MD, MCCM, speaks with Mary Jo C. Grant, APRN, PhD, about the article, Dexmedetomidine Use in Critically-Ill Children with Acute Respiratory Failure, published in the December 2016 issue of Pediatric Critical Care Medicine.
Margaret Parker, MD, MCCM, speaks with Mary Jo C. Grant, APRN, PhD, about the article, Dexmedetomidine Use in Critically-Ill Children with Acute Respiratory Failure, published in the December 2016 issue of Pediatric Critical Care Medicine.
RT Smallwood, C Demonstration Of Extubation Procedure Podcast 062315 by OPENPediatrics
Margaret Parker, MD, MCCM, speaks with Michael Gaies, MD. Dr. Gaies is an Assistant Professor and works as a Cardiac Intensivist in the Division of Cardiology, Department of Pediatrics and Communicable Diseases at C.S. Mott Childrens Hospital and University of Michigan Medical School in Ann Arbor, MI.
Margaret Parker, MD, MCCM, speaks with Michael Gaies, MD. Dr. Gaies is an Assistant Professor and works as a Cardiac Intensivist in the Division of Cardiology, Department of Pediatrics and Communicable Diseases at C.S. Mott Childrens Hospital and University of Michigan Medical School in Ann Arbor, MI.
Margaret Parker, MD, MCCM, speaks with James Thomas, MD
Margaret Parker, MD, MCCM, speaks with James Thomas, MD
Dr. Cattano is using a specialized deep extubation technique in head and neck cancer patients.
This interview took place in May at the IARS meeting in Montreal. Dr. Cooper is the current President of the Society For Airway Management, and has for many years been a advocate of extubation precautions. The closed claims database has demonstrated how there has been a reduction in claims related to induction and intubation, yet no change in claims related to the phase of extubation. Dr. Cooper gives concrete suggestions on who to be concerned about and what actions to take.
Dr. Leeor Sommer,who runs annual ENT workshops in Toronto give us his Best Case Ever involving an Extubation in the ED gone bad. In the related Episode 38 - ENT Emergencies - Pearls & Pitfalls, Tips & Tricks, Dr. Leeor Sommer and Dr. Maria Ivankovic, lecturer extrodinaire on ENT emergencies discuss: Dr. Ivankovic's stepwise approach to managing epistaxis, Tips for nasal and ear foreign body removal, How to pick up and work up the dreaded Malignant Otitis Externa, Sudden sensorineural hearing loss ('The Bells' Palsy of the Ear'), Epiglottitis work-up and management, Pharyngitis work-up and treatment - Does anyone with phayrngitis need antibiotics?, Tips and Tricks for peritonsillar abscess drainage, Hereditary and ACE-inhibitor associated Angioedema presentations and management. The post Best Case Ever 19: Extubation in the ED appeared first on Emergency Medicine Cases.
This talk deals with a very important subject (in fact it is so important there is another previous Podcast on the same subject) and it happens to be on Extubation related issues and the recently released DAS Extubation Algorithmic protocol. Click the link below to view the video.
In this podcast, I discuss extubating patients in the ED. Specifically, I deal with patients who have only been intubated for a few hours in distinction to extubation of the patient who has been lingering in your ED for 2-3 days. The best patients for this short-term extubation are those intox folks with a low GCS and signs of trauma, overdoses, or endoscopy cases.
What is the role of giving an adult steroids to prevent stridor or reintubation following extubation. This epidose looks at the data.
Medizinische Fakultät - Digitale Hochschulschriften der LMU - Teil 04/19
In der vorliegenden Arbeit wurde eine Querschnittsanalyse der Lungenfunktion und der gesundheitsbezogenen Lebensqualität bei insgesamt 50 Langzeitüberlebenden nach ARDS untersucht (im Median 5,5 Jahre nach Extubation). Das untersuchte Patientenkollektiv rekrutierte sich aus einer 1995 retrospektiv identifizierten Kohorte von 80 ehemaligen ARDS-Patienten, die zwischen Januar 1985 und Januar 1995 an der Klinik für Anaesthesiologie der Ludwig-Maximilians-Universität München behandelt wurden. Anhand der erhobenen Daten konnte gezeigt werden: 1. Bei der Mehrzahl der ehemaligen ARDS-Patienten persistieren pathologische Lungenfunktionswerte auch noch nach Jahren, wobei sich als häufigste Störung eine Reduktion des exspiratorischen Flows im Sinne einer während des ARDS erworbenen „small airway disease“ bei 32 % aller Patienten zeigte. 2. Es konnte zwischen Schwere der initialen Lungenschädigung und dem späteren Grad der Einschränkung der Lungenfunktion keine direkte Beziehung nachgewiesen werden. 3. Es besteht ein signifikanter Zusammenhang zwischen gesundheitsbezogener Lebensqualität und Zahl der eingeschränkten Lungenfunktionsparameter. 4. Bei den meisten Patienten war die gesundheitsbezogene Lebensqualität in allen Bereichen des SF-36-Scores im Vergleich zu einer alters- und geschlechtsspezifisch identischen Kontrollgruppe reduziert. Hierbei war die größte Reduktion im Bereich der auf somatischer Ebene erfassten Kategorien festzustellen, eine geringere Reduktion zeigte sich bei psychosozialen Kategorien. Erkennbar war durch Heranziehung des SF-36-Scores der Voruntersuchung ein signifikanter Trend der Besserung bei beiden Komplexen im Langzeitverlauf. 5. Lediglich bezüglich der Diffusionskapazität DLCO besteht eine positive Korrelation zwischen Normalisierung dieses Parameters der Lungenfunktion und der gleichzeitigen Verbesserung der HRQL. 6. Leichte somatische und psychosoziale Einschränkungen bei Langzeitüberlebenden nach ARDS sind häufig nach Jahren noch nachweisbar und vermutlich von bleibender Natur. 7. Der Großteil der Patienten erreicht wieder eine generelle körperliche Erholung, einen ausreichenden HRQL- Wert und war wieder in der Lage einer Erwerbstätigkeit nachzugehen. 8. Patienten, die multiple Einschränkungen ihrer Lungenfunktion nach ARDS aufweisen, sind gefährdet eine dauerhafte, schwere Beeinträchtigung ihrer körperlichen und geistigen gesundheitsbezogenen Lebensqualität zu erleiden und benötigen daher eine gründliche körperliche und psychologische Evaluierung.
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