A 62 years old male who was scheduled for emergency orthotropic liver transplantation because of hepatitis C cirrhosis, hepatocellular carcinoma and end stage liver disease. He had history of remote tonsillar cancer for which he underwent extensive surgical resection including part of his tongue as well as a skin and arterial graft from his left arm to his posterior pharynx. This was followed by radiation therapy which is associated with ongoing hemoptysis. On Examination, he is thin. Examination of his airway was concerning for an extremely limited mouth opening, and very limited neck extension. His thyromental distance also short and his throat was quite woody in that area. He had only 18 mm of inter-incisal mouth opening with muscle spasm.
| This is important because we need to look at the relevant data and realize that she seems to be in distress and first take care of that. Also realize that she seems to have an infection. With this information we are able to prioritize
Therefore, the overall prognosis is guarded in view of the underlying pathology, its extent and the post-operative respiratory insufficiency. The life expectancy is difficult to anticipate but the
Airway management is a vital part of the job of an Emergency Medical Technician (EMT). The airway is the first thing an EMT must assess in all patients, with the exception of arterial bleeding. Improper, or lack thereof, management of the airway will kill a patient; therefore EMTs must master management of the airway, for fear of dire consequences if done incorrectly. The purpose of the airway is to remove carbon dioxide and transport oxygen to the blood.
Task analysis is the process of obtaining information about a job by determining the duties, tasks, and activities involved and the knowledge, skills, and abilities required in performing each task. There can be broken down into six
What are the uses of drugs used to treat lower respiratory tract disorders: sympathomimetics, anticholinergics, inhaled steroids, lung surfactants, and mast cell stabilizers?
There are numerous different challenges that the paramedic will face in attempting to keep an airway patent. These challenges vary from patient to patient depending on their condition. One challenge in keeping a patent airway the paramedic will face is trying to maintain the airway of a trauma patient. Trauma patients make it difficult to maintain an airway due to the traumatic damage, especially if it has affected the face and neck regions.
I would tell the doctor to stop if he didn’t start and grab a manual ventilator and try to find a replacement mechanical ventilator.
The following case study is of a 37-year old Hispanic male weighing 145 lbs and 70 inches tall found unconscious by his girlfriend. According to her he was unconscious for about 15 hours and she was concerned because he would not wake or respond and was breathing shallow and slow. She then called 9-1-1. The patient entered the ER by emergency vehicle and on my initial assessment Pt had an altered mental status, was very unresponsive showing symptoms of a possible drug overdose. The girlfriend told the physician the Pt had taken 75 mg of methadone and an unknown amount of Xanex and other amounts of Benzodiazepines. On assessment, the doctor noticed his altered mental status and unconscious status. He had a gag
Mr. Joseph is a 56-year-old has 30 smoking pack years. He was diagnosed 10 years ago with asthma/chronic bronchitis, arthritis of the knees, and congestive heart failure (CHF). Mr. Joseph weighs 350 pounds with a height of 6 feet, making his body mass index (BMI) of 47.5, much more than the recommended 25, and in fact his BMI places him in the morbid obesity classification. He takes medicines for his pulmonary conditions, along with a diuretic.
Breathing is a vital process for every human. Normal breathing is practically effortless for most people, but those with asthma face a great challenge. During an asthma attack, breathing is hampered, making it difficult or even impossible for air to flow through the lungs. Asthma is an increasingly common problem, and has become the most common chronic childhood disease. At least 17 million Americans suffer from it(1), and although it can be fatal, it is usually not that severe(4). There is no cure for asthma, but with proper care, it can usually be controlled.
Throughout the years knowledge about asthma has grown, as well as treating it effectively. Over 300 million people are said to be victims of this disease with another 100 million being estimated by 2025 globally (Currie and Baker, 2012). In the United Kingdom, asthma is increasingly becoming one of the leading disease affecting individual of different age, ethnicity, race and gender. British Lung Foundation (2011) stated that it is more common at childhood stage and can also occur at a later age. According to Asthma UK (2014) asthma in men is less prevalence than it is in women and children troubled more with asthma than adults. Recent data in the UK shows that in children and occupational asthma in adult is on the rise with an estimate
Chronic obstructive pulmonary disease (COPD) remains a major financial burden to our healthcare system. In 2015, the Centers for Medicare & Medicaid Services started imposing a financial penalty for hospitals with excess rates of COPD readmissions. We investigated the effectiveness of a Discharge Checklist in reducing the rates of 30-day readmission in a cohort of high risk patients admitted with COPD exacerbation.
I then needed to carry out a respiratory assessment. I observed Mr Brown’s chest for any visible signs of scars or trauma. This appeared normal.
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.
CASE ONE CONTINUED: She returns in three weeks. Her chest X-ray was normal. Her symptoms are unchanged.