Podcast: Play in new window | DownloadSubscribe: Apple Podcasts | RSSTweet This is the second chat with Thomas Piraino (@respresource) who is a Clinical Specialist in mechanical ventilation at the Centre of Excellence in Mechanical Ventilation, St. Michael’s Hospital. We are moving onto some of the more complex modes of ventilation here with more variability […]
Podcast: Play in new window | DownloadSubscribe: Apple Podcasts | RSSTweet The third in the series with Ollie Poole (@RespReview) on mechanical ventilation. Ollie goes into some more detail on the phases of the breath. This requires some visualisation of the waveform involved. Below is the video from YouTube that Ollie originally produced which should […]
Tweet Abstract Study Objective: To evaluate the influence of nasal oxygen (O2) administration on the duration of arterial oxygen saturation (SpO2) ≥95% during simulated difficult laryngoscopy in obese patients. Design: Prospective, randomized, controlled trial. Setting: University hospital. Patients: 30 obese men undergoing general anesthesia. Interventions: After thorough preoxygenation, and using total intravenous anesthesia, simulated difficult […]
Tweet In mechanically ventilated patients without ARDS at the time of endotracheal intubation, the majority of data favors lower tidal volume to reduce progression to ARDS. However, due to significant heterogeneity in the data, no definitive recommendations can be made. Further randomized controlled trials examining the role of lower tidal volumes in patients without ARDS, […]
Tweet The Main Question: Is there any evidence for the efficacy of cricoid pressure in reducing aspiration? The short answer is no. A systematic review intended to answer this question was published in the Canadian Journal of Anaesthesia in 2007 and concluded, “Following our analysis of the literature it was apparent that there was no […]
Podcast: Play in new window | DownloadSubscribe: Apple Podcasts | RSSTweet I love the world of social media. It was through the medium of Twitter that I was able to connect with James DuCanto (@jducanto)who is an anesthesiologist at Aurora Health Care in Wisconsin. Gavin Denton (@DentonGavin) and I picked his brains about some of […]
Tweet Nearly 800,000 patients require mechanical ventilation yearly. There’s no doubt it is a life-saving intervention, but it is one that is fraught with the potential for iatrogenesis, especially if continued for longer than necessary. That is the main message of this review in the NEJM by John F. McConville and John P. Kress (father of the sedation holiday) from the University of […]
Podcast: Play in new window | DownloadSubscribe: Apple Podcasts | RSSTweet http://traffic.libsyn.com/criticalcarepractitioner/CCP_034.mp3 In this podcast I carry on my conversation with Ollie Poole (@respreview) about some of the issues with mechanical ventilation. We talk about the different types of breath and why we use them. This then helps us identify some of the very confusing […]
Tweet Noninvasive ventilation (NIV), as a weaning-facilitating strategy in predominantly chronic obstructive pulmonary disease (COPD) mechanically ventilated patients, is associated with reduced ventilator-associated pneumonia, total duration of mechanical ventilation, length of intensive care unit (ICU) and hospital stay, and mortality. However, this benefit after planned extubation in patients with acute respiratory failure of various etiologies […]
Tweet One of my very bright colleagues, Gavin Denton, did a review of the literature around apnoeic oxygenation using the best bets format. In his words: “At the least, apnoeic oxygenation does no harm, and is a cheap and accessible technique that can be added to a pre-oxygenation method during an attempt of endotracheal intubation. […]
Tweet Purpose: We aimed to survey the members of anesthesia departments in two large university hospitals, University of Washington (Seattle, USA) (UW-US) and University of Nottingham (Nottingham, UK) (UN-UK) to compare differences in their current approach to rapid sequence induction (RSI). Link here..
Podcast: Play in new window | DownloadSubscribe: Apple Podcasts | RSSTweet I thought it was time we explored the subject of mechanical ventilation again and so I reached out on Twitter and am now joined by Thomas Piraino (@respresource) who is a Clinical Specialist in mechanical ventilation at the Centre of Excellence in Mechanical Ventilation, […]
Tweet Early use of high frequency oscillatory ventilation doesn’t lower and may increase hospital mortality..here
Podcast: Play in new window | DownloadSubscribe: Apple Podcasts | RSSTweet RSI My good friend Dr. Nitin Arora and I had a discussion about the various combinations of drugs which can be used during a rapid sequence induction or RSI and the reasons for giving them. Sometimes its not always evident why the doctor wants […]
Tweet Performance of ultrasonography for the detection of pneumothorax is excellent and is superior to supine chest radiography. Considering the rapid access to bedside ultrasonography and the excellent performance of this simple test, this study supports the routine use of ultrasonography for the detection of pneumothorax. Link to research paper here…
Tweet Jim DuCanto is back, innovating on body positioning and how the way you hold the laryngoscope might improve glottic visualisation.
Tweet Surveillance for VAP is subjective and labor intensive. VAC is an objective measure which can be readily obtained from electronic records. It is associated with adverse outcomes and increased broad-spectrum antibiotic usage. VAC may be a useful surveillance tool. The utility of VAC prevention bundles merits assessment….link here
Tweet This article reviews preoxygenation and peri-intubation oxygenation techniques to minimize the risk of hypoxemia during emergency tracheal intubation of adult patients. It introduces a risk-stratification approach based on initial pulse oximetry level in response to oxygen administration and provides recommendations about specific techniques based on periprocedural risk. Techniques reviewed include positioning, preoxygenation and denitrogenation, […]
Tweet Rich Levitan delivers an excellent lecture on good intubation technique. From EmCritBlog.
Tweet Is there a need for active ventilation during ALS? Could we go passive? Some discussion….here