By Florian Falter
This instruction manual is a advisor to most sensible perform in interventions in general encountered within the ICU. it truly is clinically oriented offering :step-by-step factors and illustrations of so much invasive systems, payment lists to ensure the indication is true, cost lists to make sure applicable evaluate as soon as the strategy has been conducted. the data is definitely available supplying useful recommendation and crucial historical past for each member of the multi-disciplinary staff taking care of seriously ailing sufferers. it's going to serve the senior advisor who has now not played a approach for it slow in addition to the junior healthcare professional short of an aide memoire.
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Extra resources for Bedside Procedures in the ICU
In most units a portable chest X-ray is performed to exclude a pneumothorax, although it has been suggested that this may not be mandatory where placement has been uncomplicated and visualized bronchoscopically. Once neuromuscular blockade has faded, sedation can be lightened. Common Complications • Bleeding from the venous system of the anterior neck is commonly encountered. While obvious large veins will be avoided during the procedure, smaller ones may be torn during dilation. Firm pressure will usually be sufficient to 46 • • • • • R.
4) Indications • Maintaining airway patency in patients with a reduced level of consciousness or requiring sedation. • Airway protection in patients at risk of aspiration. • Prevention of complete airway obstruction. • Ventilation in patients with Type 1 or Type 2 respiratory failure. • Clearance of bronchial secretions in patients with poor cough. Preparation • Depending on the size and the layout of an ICU at least one airway trolley with intubation equipment (see Fig. 7) should be in an easily accessible location.
Factors associated with difficult intubation include − − − − − − − − − Obesity Short wide neck Reduced neck extension Prominent upper incisors Receding chin Reduced mouth opening Presence of beard Swollen tongue Facial trauma 22 M. g. laryngeal mask airway Depending on the expertise of the operator, the presence of one or more of these factors should prompt a call for more experienced help. • A sedative and a muscle relaxant are needed for intubation. Emergency drugs in case of hypotension or bradycardia should also be to hand.
Bedside Procedures in the ICU by Florian Falter