Tag: tracheostomy
Elective Tracheostomy During COVID-19: To Whom, When, How?
We suggest to wait at least 14 days to perform tracheostomy. In patients with SOFA score > 6 and D dimer > 4, tracheostomy should not be performed or should be postponed. Optimized procedures and enhanced personal... read more
Comparison of outcomes between vertical and transverse skin incisions in percutaneous tracheostomy for critically ill patients
This retrospective study showed that transverse skin incisions in PTs for critically ill patients, resulted in a significant decrease in overall complications, particularly ulcers in the tracheostomy site. Of the 458... read more
Timing of Tracheostomy in Pediatric Patients
In children on mechanical ventilation, early tracheostomy may improve important medical outcomes. However, our data demonstrate the urgent need for high-quality, randomized controlled trials in the pediatric population. Data... read more
Urgent Intubation without Neuromuscular Blocking Agents and the Risk of Tracheostomy
Neuromuscular blocking agents play a significant role in improving the success rate for urgent intubation, although there is limited evidence about the effect on subsequent outcomes, such as the incidence of tracheostomy.... read more
Safety of Early Tracheostomy in Trauma Patients After Anterior Cervical Fusion
Cervical spine injuries (CSIs) can have major effects on the respiratory system and carry a high incidence of pulmonary complications. Respiratory failure can be due to spinal cord injuries, concomitant facial fractures or... read more
Score for Predicting Ventilator Weaning Duration in Patients With Tracheostomies
A score derived from ventilator settings may help clinicians predict the timing of ventilator liberation in patients requiring prolonged mechanical ventilation. Of 372 patients, 72% were liberated from mechanical ventilation.... read more
Trach Travails: Need-to-Know ED Tricks for Airway Emergencies in Tracheostomy Patients
The outside hospital emergency physician passed a bougie through the patient’s existing metal trach and exchanged the metal trach for a 6-0 endotracheal tube. After the exchange, the ETT cuff was inflated, and the patient... 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
Evaluating the Cost-Effectiveness of Proportional-Assist Ventilation Plus vs. Pressure Support Ventilation in the ICU in Two Countries
The published reductions in asynchrony and length of stay in the ICU with proportional assist ventilation (PAV ventilation by Medtronic) led to shorter time on ventilation, and reduced incidence of ventilator-associated pneumonia... read more
The Role of Speech and Language Therapy in Critical Care
The role of speech and language therapists (SLTs) in critical care can be unclear so this article sets out the scope of practice to increase awareness of the value of SLTs as part of the wider multidisciplinary team. Speech... read more
Comparison between a nurse-led weaning protocol and weaning based on physician’s clinical judgment in tracheostomized critically ill patients
In this pilot RCT we demonstrated that a nurse-led weaning protocol from tracheostomy was feasible and safe. A larger RCT is justified to assess efficacy. We enrolled 65 patients, 27 were in the protocol group and 38 in the... read more
Bleeding During Percutaneous Dilatational Tracheostomy – What to do while waiting for the surgeon?
A patient suffered significant bleeding during an attempt at percutaneous dilatational tracheostomy due to an aberrant anterior jugular vein. Bleeding was controlled with pressure temporarily, but quickly returned necessitating... read more
National Variation in the Use of Tracheostomy in Children Undergoing Congenital Heart Surgery
Variation in the usage of tracheostomy in infants and children undergoing congenital heart surgery exists across the country. High-tracheostomy centers had lower hospital charges. Late tracheostomy placement, higher congenital... read more
Patients want to be heard loud and clear!
We congratulate ten Hoorn et al. on their systematic review of communication with ICU patients. Their work in defining an algorithm to assist improving communication options for these patients addresses a clear gap in patient-centred... read more
