A Research Article On Accidental Decannulation Following Placement Of A Tracheostomy Tube

Mrs. Helen Bessler, mother of George Bessler, was hospitalized 16March2015 and underwent surgery of the right lung on 17March2015. She had cancer of the right lung that required removal of two lobes and a section of the superior vena cava.

The author of the article is Walsh, Timothy who has an MD a graduate of Princeton University and of Harvard Medical School. The article was originally published at an organizational site called the American Association for the Advancement of Science, in 1998. The web site was last update on February 24, 2016. The information on the article seems accurate and reliable although sometimes on organizational sites the information is biased toward the

ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).

A degree of evidence related to protocol usage and outcomes was collected to determine if a researchable problem was obtainable and valuable. According to Davies (2011), research questions should concentrate on "real-world problems" (p. 75). Patients in the intensive care unit who are mechanically ventilated receive intravenous sedation on a regular basis. According to findings by Wøien, Vaerøy, Aamodt, and Bjørk (2012), as much as "30-60% of intensive

Although when it happens, there can be a devastating impact on patients as well as to the multidisciplinary theatre team involved. Consequently, the DAS has produced a consensus set of guidelines for managing failed intubations in adult and paediatric patients, but there are as yet no such nationally-agreed guidelines in obstetrics, therefore each obstetric unit should have their own flowchart with regards to management of failed intubation (Brien and Conlon, 2013). Furthermore, in light of the latest DAS guidelines, several aspects of clinical anaesthetic practise have changed over recent years (Frerk at al, 2015). Amongst the changes are the use of new drugs such as rocuronium and suggamadex and using electronic video-laryngoscopes (Frerk et al, 2015). Further work had also looked at extending the period of apnoea without causing desaturation by optimising the preoxygenation process and adequate patient positioning (Frerk et al, 2015). As a result, updated guidelines for difficult intubations in adult patients were published in 2015; these guidelines provide a flowchart to be used when endotracheal intubation proves difficult or impossible and focus on the central importance of oxygenation while reducing the amount of airway interventions in order to minimize trauma to the delicate airway (Frerk et al, 2015). The main message of the revised guidelines is

This study focuses on methods to confirm proper tube placement. Through a cross sectional study, the research concluded that over seventy eight percent of critical care health workers use multiple methods to confirm tube placement. Some of the more common methods include looking at the gastric aspirate’s pH, observing the patient for signs or respiratory distress, and capnography. Auscultation of the air bolus was not included in the study because it was deemed “unreliable”. However, a small separate study was done and about eighty eight percent of critical care health workers claimed they also used an air bolus auscultation as a method of confirming placement. So, what is the reasoning for health care workers to continue doing this if it is unreliable? It has been hypothesized that this method requires the least amount of supplies and the nurses can do it quickly and easily. This research study along with many others concludes that air bolus auscultation is not an accurate method because the sounds nurses are used to hearing that “confirm” proper tube placement in the gastrointestinal tract are the same as sounds heard in the lungs and other areas of the

The key concept underpinning the role of the anaesthetic nurse in an unanticipated difficult intubation as part of the multidisciplinary theatre team is essential; as a lead provider of compassionate anaesthetic care (Fynes et al, 2014), as a communicator, have the courage to advocate, be competent and committed (DOH, 2012). These are very important for enhancing patient anaesthetic care and improving patient safety (NPSA, 2010). And above, to improve the knowledge and skills by continuous training is vital in the event of a difficult intubation in adults, pregnant women and children (Brien and Conlon, 2013; Clark and Nolan, 2010). The incident confirms that to improve airway management, especially in the event of a difficult intubation planning, training and practising (such as in simulation centres) for the unanticipated difficult airway for the anaesthetist, anaesthetic nurse and theatre staff as a whole, is vital and it highlighted that our practice around managing the airway needs to be improved and constantly updated (Mellanby, Podmore and McNarry, 2014), and that is why I have applied to take part in the new airway simulation training

Furthermore Polit and Beck (2006) adds that some researchers will refer this as the purpose of the study however, either way the introduction should at least generally indicate to the reader what is to be studied. The researchers have stated the funders of the research, which is funded research by Department of Health, which could suggest to be biased politically, however the motive is difficult to frame.

Ventilator-associated pneumonia is a bacterial infection that occurs in the lower respiratory system within the first 48 hours of endotrachal intubation (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). Although any hospital patient is susceptible to pneumonia, ventilator dependent patients are at the highest risk of acquiring pneumonia. The purpose of this paper is to identify the risk factors, incidences, and preventions of ventilator-associated pneumonia (VAP) using a quantitative research study performed in Malaysia. “The aim of this

UE is a serious event that presents as a patient safety and quality improvement concern in the critically ill infant in the NICU. An UE is the premature removal of the endotracheal tube per the patient or staff (accidentally or deliberately) while a patient is receiving invasive mechanical assistance. This occurrence can have significant risk consequences and is considered a potentially life threatening event due to the loss of airway control and mechanical support. Sometimes it is possible for the infant to develop hypercarbia, hypoxia, airway trauma, ventilator-associated pneumonia, intraventricular hemorrhage, and

Respiratory therapists have one of the most exciting and gratifying careers within the medical field. Unfortunately as with any other job or career, it doesn’t come without having challenging times. Respiratory therapists work along-side physicians and are highly trained to treat patients with any sort of lung concern or breathing complications. This job requires hands on care, and deals with life and death daily. One specific scope of this field involves caring for patients (of all ages) attached to mechanical ventilation. It is the respiratory therapists’ responsibility to remove assistive ventilation to patients with written order from the doctor; which ultimately results in death of the patient (Keene, Samples, Masini, Byington).

These episodes are also summarized versions of research articles which means that important information can excluded. This omission of information can then be misleading to the general public. In regards to the research article the type of study conducted comes with its own weaknesses. Since the study is longitudinal there is a risk of attrition or loss of participants. Participants who may have had low academic achievement and were the oldest child may have dropped out of the study which could lead to the results the researchers

In the article, unplanned extubation (UE) is shown to be one of the complications that occur frequently with mechanical ventilation in neonates in the neonatal intensive care unit. This warranties the trial of other techniques such as Noninvasive ventilation (NIV). According to the author, this technique is only adequate for neonates that display adequate respiratory effort. In the article, a study was carried out to determine the effectiveness of NIV in providing ventilatory support in neonates with unplanned extubation as a result of the use of conventional ventilatory techniques. The study extended to establish instances that NIV failed to restore the condition in neonates.

a. The study was conducted in accordance with the ‘Recommendations Guiding Physicians in Biomedical Research Involving Human Subjects’ in the 1989 Declaration of Helsinki.

Normal respiration consists of inhalation and exhalation. Inhalation is taking in oxygen and delivering it to all cells in the body and exhalation is picking up carbon dioxide waster product of cells and taking it out. Air travel from the nose or mouth into the larynx into the trachea and ends up in the lungs where oxygen is dropped and carbon dioxide is picked up. Oxygen is really important for cell function and when oxygen is not delivered, cells begin to die. So when process of breathing does not work properly other methods of delivering oxygen are used such as tracheostomy.