Tag: oxygenation
Lumping or Splitting in Pediatric ARDS
Improvements in acute respiratory distress syndrome (ARDS) outcomes in adults have been achieved along-side demonstration of the superiority of low-tidal volume ventilation, the relative advantage of a restrictive fluid strategy... read more
High Flow Nasal Cannula (HFNC) – Part 1: How It Works
The use of heated and humidified high flow nasal cannula (HFNC) has become increasingly popular in the treatment of patients with acute respiratory failure through all age groups. I first started using it as a pediatric intensive... read more
Oxygenate, Ventilate, Do No Harm
Emergency physicians (EPs) are experts in emergent airway management and thus must be confident managing mechanical ventilation. Hospital-wide bed shortages mean that EPs will be managing admitted patients for longer periods... read more
Critical Hemoglobin Desaturation Will Occur before Return to an Unparalyzed State following 1 mg/kg Intravenous Succinylcholine
The American Society of Anesthesiologists (ASA) difficult airway algorithm recommends that if initial attempts at tracheal intubation after the induction of general anesthesia are unsuccessful, the practitioner should "consider... read more
Functional Status Change Among Children With ECMO to Support Cardiopulmonary Resuscitation in a Pediatric Cardiac ICU
This is the first extracorporeal cardiopulmonary resuscitation report to examine changes in Functional Status Scale from admission (baseline) to discharge as a measure of overall functional outcome. Half of surviving patients... read more
Neurally adjusted ventilatory assist
Several studies nowadays prove the physiological benefits of neurally adjusted ventilatory assist, as opposed to the conventional modes of partial support. Whether these advantages translate into improvement of clinical outcomes... read more
Guidelines for the Management of Tracheal Intubation in Critically Ill Adults
These guidelines describe a comprehensive strategy to optimize oxygenation, airway management, and tracheal intubation in critically ill patients, in all hospital locations. They are a direct response to the 4th National... read more
Rapid Sequence Intubation With Video Laryngoscopy Common for Difficult Airways
Predicted difficult airways in one emergency department are managed most often using rapid sequence intubation (RSI) and video laryngoscopy (VL), a recent study has found. Although difficult airways occur frequently in emergency... read more
A Nightmare Airway with Rob Bryant
In terms of airway management, cricothyrotomy is one of the most advanced airway procedures an ED physician will perform. It is a last resort procedure when a patient is not able to be ventilated/oxygenated and/or intubated.... read more
The Answer My Friend is Blowin’ in your Nose – High Flow Nasal Oxygen
High flow nasal oxygen is a novel device that actively humidifies and heats air to make flows of up to 60 liters a minutes tolerable. These incredibly high flows are important, because in order to provide 100% fiO2 to patients... read more
A Basic Approach to Treating Various Types of Hypoxia
The use of supplemental oxygen is of no value when treating stagnant and histotoxic hypoxia because the problem is due to impaired cardiac function and cell enzyme inhibition respectfully. Supplemental oxygen is of little... read more
Oxygen: Savior or Devil in a Green Dress?
If you ask any small child what doctors do or what happens in a hospital, you'll probably get some variation of "they make sick people better." Were you to ask the same question of one of those doctors or someone working... read more
Resuscitation Sequence Intubation – Hypoxemia Kills
This blog post is the second part of a series of 3, on a recent lecture I was asked to give on Critical Care Updates: Resuscitation Sequence Intubation. This talk was mostly derived from a podcast by Scott Weingart (Twitter:... read more
ECMO – How can I make the best referral?
Extracorporeal membrane oxygenation or ECMO is one of those treatments we sometimes need to think about with our very sick patients. I recently had to make a referral to my local centre and doing so made me wonder what it... read more
The A1 Sedation Package: Better Care for Intubated Patients
You are called to the scene of a 56-year-old male found unresponsive in his garage workshop. Upon examining him you find him minimally responsive to painful stimulus, moaning and groaning. His family tells you he has high... read more
Techniques for the Difficult Airway
A systematic approach to intubation that emphasizes planning and teamwork can reduce intubation complications. Early use of an EGA or cricothyroidotomy may reduce complications when oxygenation is inadequate. Use of a gum... read more
The 16-year-old Girl Who Walks and Eats Tacos While on Life Support
In November, the otherwise healthy teen was placed on life support in the pediatric intensive care unit at Children's Mercy Hospital in Kansas City. Now, more than 130 days later, Zei's determination and independence have... read more
