If only medical or health care will teach this way. No need for “ you should already know this”. How refreshing that someone so accomplished as this MD humbly enough stated “didn’t encounter this as much”. Nobody stated “to blunt the end of tracheostomy tube to avoid fistula”. Simple to the fact and effective way of remembering a rationale. First couple mins and I’m hooked. Ty!
Thank you so much for this. I'm a home health nurse & I'm getting a vented trached patient who I will be watching at night while they sleep. This was super informative & I feel so much more comfortable now that I know this info.
1:18 - - (44 y/o OD’d on heroine in ER, PA arrest, prolonged resuscitation, severe anoxic brain injury) 1:10 - - 9 days s/p trach, *tachycardic,* “sick kipnuk”(?), severe respiratory distress, hypertensive 1:35 - - 110,000 tracheostomies performed annually in the US 1:43 - - 40-50% of trached patients will have a complication (most in ICU), most minor req minimal intervention 1:54 - - (1% of trached patients suffer a catastrophic airway complication) 1:59 - - *HALF of airway deaths in ER or ICU are due to DISLODGMENT or DECANNULATION*
Great video, very helpful, thank you!! Question please: wouldn’t it make more sense to deflate cuff and reposition existing inner cannula as step 2, BEFORE removing the inner cannula and suctioning?
Great review. I would add one note of caution against silo thinking by focusing exclusively on the tracheostomy in a hypoxemic patient. What if you run this brief algorithm but the patient does not improve? One other consideration in these patients is they are particularly susceptible to mucus plugs which can suddenly obstruct an entire bronchus. The airway will be clear but the patient's dropped a lung- acts like a PE but there will be absent breath sounds and a CXR will be whited out on that side. Identifying may be easier than fixing; you can try deep suction, mucomyst nebs, chest percussion, anything to knock the plug loose. Disclaimer- do not listen to me 🤘.
Thank you for this video. Can you please explain how a ruptured cuff wouldn't be signalled by the pilot balloon? Shouldn't that be something that stands out to the clinician? Just asking.
@@CriticalCareNow A leak slow enough to leave the balloon inflated shouldn't cause this type of decompensation and need for urgent tube exchange though. Just reinflate the cuff and they'll be fixed (temporarily).
Sister my brother now admit in ksa hospital doctor say can suggested with family i will fix the neck tube or u suggested me if no danger this then I will give the operation order please?
![Blox Fruits Dragon Rework Update [Full Stream]](http://i.ytimg.com/vi/EqDAp8udhm0/mqdefault.jpg)
If only medical or health care will teach this way. No need for “ you should already know this”. How refreshing that someone so accomplished as this MD humbly enough stated “didn’t encounter this as much”. Nobody stated “to blunt the end of tracheostomy tube to avoid fistula”. Simple to the fact and effective way of remembering a rationale. First couple mins and I’m hooked. Ty!
Thanks for watching!
I use this to refresh on trachs in the field as a paramedic. I've had a couple of bad trach patients and I always come back to this as a refresher
Awesome. Thanks
Thank you so much for this. I'm a home health nurse & I'm getting a vented trached patient who I will be watching at night while they sleep. This was super informative & I feel so much more comfortable now that I know this info.
thanks
1:18 - - (44 y/o OD’d on heroine in ER, PA arrest, prolonged resuscitation, severe anoxic brain injury)
1:10 - - 9 days s/p trach, *tachycardic,* “sick kipnuk”(?), severe respiratory distress, hypertensive
1:35 - - 110,000 tracheostomies performed annually in the US
1:43 - - 40-50% of trached patients will have a complication (most in ICU), most minor req minimal intervention
1:54 - - (1% of trached patients suffer a catastrophic airway complication)
1:59 - - *HALF of airway deaths in ER or ICU are due to DISLODGMENT or DECANNULATION*
This was great, thanks for the lecture and thank you guys for posting it!
Thank you!
Great video, very helpful, thank you!!
Question please: wouldn’t it make more sense to deflate cuff and reposition existing inner cannula as step 2, BEFORE removing the inner cannula and suctioning?
Inner cannula removal can restore airflow faster than repositioning
Great review. I would add one note of caution against silo thinking by focusing exclusively on the tracheostomy in a hypoxemic patient. What if you run this brief algorithm but the patient does not improve? One other consideration in these patients is they are particularly susceptible to mucus plugs which can suddenly obstruct an entire bronchus. The airway will be clear but the patient's dropped a lung- acts like a PE but there will be absent breath sounds and a CXR will be whited out on that side. Identifying may be easier than fixing; you can try deep suction, mucomyst nebs, chest percussion, anything to knock the plug loose. Disclaimer- do not listen to me 🤘.
Thanks for your comment and I won’t listen to you
Thank you because I am caring for my fiance, and I want to familiarize myself he has had mucus plugs..so I want to make sure he doesn't aspirate.. TY
You’re welcome. Good luck
Great lecture, thank you
Thanks for dropping a comment.
Thank you for this video. Can you please explain how a ruptured cuff wouldn't be signalled by the pilot balloon? Shouldn't that be something that stands out to the clinician? Just asking.
Thanks for your comment. Sometimes a partial rupture results in a slow leak and pilot looks okay.
@@CriticalCareNow thanks!
@@CriticalCareNow A leak slow enough to leave the balloon inflated shouldn't cause this type of decompensation and need for urgent tube exchange though. Just reinflate the cuff and they'll be fixed (temporarily).
ON POINT GIRL
Thanks
Sister my brother now admit in ksa hospital doctor say can suggested with family i will fix the neck tube or u suggested me if no danger this then I will give the operation order please?
Sorry to hear. Good luck
@@CriticalCareNow this tube fix to temporarily or the long time ?
@@HayatKhan-mp8oc it can be either.
@@CriticalCareNow I'm very sad just praying for my brother tomorrow input 🤲🤲
Would appreciate if also with sampling of ET secretion
Applet your comments
awesome lecture
Thanks for that!
my trach keeps draining how do i fix it?
Please see your doctor immediately
my brain hurts. great video
Thanks
Good good.
She’s the best!
Something got stuck? What do I do? I think it's broken
go to the ER now
@@CriticalCareNow that was scary but still alive
Great
Thanks
Does Dr. Emily Damuth have instagram?
I don’t think so but she’s on Twitter
we are manufacturer of closed suction catheter in China, CE approved.
congratulations
she provides great information but speaks too fast
Thanks
the information is great but she speaks too fast
Thanks