Post-extubation stridor
Post-extubation stridor is the presence inspiratory noise post-extubation indicated narrowing of the airway (can be supraglottic, but usually glottic and infraglottic)
Laryngospasm
Laryngospasm is potentially life-threatening closure of the true vocal chords resulting in partial or complete airway obstruction unresponsive to airway positioning maneuvers.
Indices that predict difficulty weaning
Numerous objective indices have been studied to predict failure of ventilator liberation or weaning. None of these indexes alone are sufficiently sensitive and specific to be useful in predicting the success of ventilation discontinuation in an individual patient.
Spontaneous Breathing Trial
Spontaneous breathing trials (SBT) are used to identify patients who are likely to fail liberation from mechanical ventilation
Tracheostomy Complications
Tracheostomy complications can be immediate, delayed or late
Anatomy for Tracheostomy
To perfrom a tracheostomy, knowledge of the following is required: surface anatomy, course of the trachea, structure of the tracheal rings, layers of dissection, components of the larynx and related structures
Assessment of Swallow in a Tracheostomy Patient
The presence of a tracheostomy tube can adversely effect swallowing: in patients who previously had no dysphagia; and further impair swallowing function in those who already have neurological or mechanical disorders of swallowing.
Fenestrated Tracheostomy Tube
fenestrated tracheostomy tube. allows patient to breath normally with a tracheostomy in situ. patient can cough and speak through mouth. improves swallow function. acts a step prior to decannulation
Timing of Tracheostomy
Tracheostomy is performed in critically ill adults requiring prolonged invasive ventilation as a strategy to: — reduce respiratory tract injury — improve patient comfort, and/or — to facilitate weaning
Tracheostomy ready for decannulation
Is this tracheostomy patient ready for decannulation? Hot Case
Weaning from Mechanical Ventilation
Ventilator management should be aimed at getting the patient off ventilator support as rapidly as possible. Weaning can be considered once the underlying process necessitating mechanical ventilation is resolving
Meow-Meow Mephedrone
Mephedrone is a new stimulant drug being abused on the street, and has recently been discovered in Australia. The following review provides emergency clinicians with assessing managing patients under the influence of mephedrone.