Bedside Procedures in the ICU by Christiana C. Burt, Jurgens Nortje (auth.), Florian Falter

By Christiana C. Burt, Jurgens Nortje (auth.), Florian Falter (eds.)

This instruction manual is a consultant to top perform in interventions more often than not encountered within the ICU. it truly is clinically oriented offering :step-by-step motives and illustrations of so much invasive strategies, cost lists to ensure the indication is correct, money lists to make sure applicable overview as soon as the strategy has been performed. the knowledge is definitely available supplying sensible suggestion and crucial historical past for each member of the multi-disciplinary group taking good care of severely in poor health sufferers. it's going to serve the senior advisor who has now not played a process for it slow in addition to the junior health professional short of an aide memoire.

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At least one trained assistant is required. Technique • The patient should be pre-oxygenated with high flow oxygen via a tightly fitting mask for at least 3 min prior to giving Chapter 2. 8 Cricoid pressure during rapid sequence intubation • • • • intubation drugs. This prolongs the length of time before the patient starts to desaturate during attempts at intubation. A sedative drug is usually required, with doses reduced in patients with reduced GCS or cardiovascular instability. Opiates given concurrently may improve cardiovascular stability.

The development of arrhythmias is usually transient but may require short- term anti-arrhythmic treatment. • Fever associated with FOB is mostly short lived but may persist and require antimicrobial treatment. • Bleeding after biopsies is often manageable with topical application of 5 mL of adrenaline 1:10000 and/or cold 34 K. S. Parmar a b Chapter 3. 3 (continued) saline. If this fails to stop the bleeding, radiology and thoracic surgery should be involved as early as possible. • Most post biopsy pneumothoraces can be managed conservatively.

Opiates given concurrently may improve cardiovascular stability. In patients at risk of aspiration of gastric contents, a rapid sequence technique is used, with a fast acting muscle relaxant and cricoid pressure. It is given by placing thumb and index finger on either side the cricoid ring and applying 30N of pressure. As the cricoid ring is a complete cartilaginous ring, it compresses the esophagus and prevents reflux of gastric contents (see Fig. 8). Cricoid pressure should be started as soon as the patient loses their airway reflexes, and should be maintained until a definitive airway is established.

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