Airway Discussion Paper

Adequate qualified medical staff must be present in all critical care areas caring for mechanically ventilated

Once on scene, paramedics began to treat the unconscious Villella for his injuries. As part of their treatment, the paramedics inserted an endotracheal tube into his trachea, in an attempt to secure his airway (Brody & Acker, 2010). While in

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

Instilling normal saline solution before endotracheal suctioning improves oxygenation, facilitates removal of secretions, and stimulates coughing to mobilize secretions. Is this to be considered evidence practice? Suctioning is one of the main procedures used by respiratory therapist and nurses in the acute care and home health to help patients who require the use of a ventilator. According to the literature there is little research supporting the practice of instilling normal saline prior to suctioning. In contrast, studies have revealed this practice is more dangerous because it increases the risk of ventilator associated pneumonia. (Miller, Drummond, & Carey, 2015). This type of pneumonia occurs when bacteria is present in the saline vials. The evidence based practice of sacred cow proposes this practice of saline instillation prior to suctioning a patient prior to intubation should not be done.

At various stages of asthma, preventative measures can be used to control or alleviate the symptoms associated with this disease. Education is an important component to every intervention phase, particularly in primary prevention, because the patient is encouraged to be proactive with their personal health in order to avoid and control the triggers. Prescribed medication, such as an inhaler, and an action plan that is individualized to the specific care of a particular patient is essential in the secondary prevention phase. Finally, in the tertiary prevention phase, the care is directed not only at the common asthmatic symptoms and triggers but also at the complications that result from long-term suffering of this disease. This paper focuses on environmental factors which trigger asthma, with specific focus on children from infancy to 16 years of age in low-income housing, and how the appropriate measure can minimize the triggers and symptoms. The New York City Housing Authority (NYCHA) is the example we will use.

The main priority for all the pediatric patient was to make sure they are getting enough air. They needed an open airway. Without an open airway nothing else matters. To help with the patients airways we monitored their O2 sats and if they were low we made sure to apply oxygen, and continue to monitor their sats. Once oxygen was applied we worked on

In the field of emergency medicine there are few things that are valued as much as a patent airway. From the very beginning stages of training in emergency care we are taught to monitor for airway, breathing and circulation .A patent airway is a very important part of the ABCs triangle necessary to support life. There are many causes of airway compromise, however we will look at basic foreign body airway obstructions and what we can do to fix them.

Working as a paramedic I have encountered patients that required the use of my critical thinking ability, help successfully set up proper equipment for team members to successfully establish an airway, assessing, intervening and stabilizing patients, and understanding ventilator management.

Teamwork and Collaboration: Overall, Tracheotomy was one person's job. At the hospital I would collaborate with other nurses to clean the inner cannula, and to put restraint on Mr. Harrison's wrist to prevent Mr. Harrison from pulling the tracheotomy. I would work together with Mr. Harrison or his family member, and find ways for him to quit smoking.

One of the most common causes of an airway obstruction in unconscious patient's is their tongue. This problem can be overcome by the use of an oropharyngeal airway (OPA) or nasopharyngeal airway (NPA). These airway adjuncts are inserted into the patient's mouth or nostril, and are designed to hold the tongue in a position that prevents it from occluding the airway. Another skill authorized for BLS providers is the use of a bag-valve-mask (BVM). This tool allows EMS personnel to deliver positive pressure ventilations to a patient who is not breathing sufficiently on their own. However, this skill is commonly performed improperly. When using a BVM, an EMS provider must make certain that his patient's airway is patent, and that his head is positioned properly. Furthermore, it is critical that an EMS provider ensures that the mask is maintaining a complete seal around his patient's nose and mouth. Otherwise, pressure needed to force air into the lungs escapes through the unsealed portion of the mask, reducing the effectiveness of the ventilation. Another, more advanced skill used by EMS providers is the performance of an endotracheal

The research article being analyzed pertains to the methods of suctioning of an open system endotracheal tube in ICU patients. The study was aimed to examine the techniques and practices that ICU Nurses employ at bedside before, during and after suctioning of the open endotracheal system to compare if it is in compliance with current recommended practices and procedures. The research question is “Do ICU nurses perform quality ETS as spelled by best recommended practice?”

Respiratory emergencies can be caused by obstructions, inflammations, trauma, and several different disease processes. The most common obstruction of the airway is the tongue. This usually occurs when the patient has become unconscious secondary to another cause such as intoxication, low blood sugar, or trauma. While tongue obstruction of the airway can have deadly results, it can be easily solved by re-positioning the airway using the either the jaw thrust maneuver if trauma is suspected, or the head-tilt chin-lift if no trauma is suspected. Also if the patient is unconscious and has no gag reflex you can use an oropharyngeal airway to hold the tongue up and out of the airway. However, using an oropharyngeal airway does not mean that you can

I tried diaphragmatic breathing and alternate nostril breathing. I am still having a bit of hard time using diaphragmatic breathing while I am sitting. However, I've been doing laying down and it has worked wonders. I was actually able to fall asleep faster and slept more soundly than before. If my son would actually sleep through the night, it would probably be the best sleep I have had in over 3 years. My attempt at alternate nostril breathing did not go so well. Each attempt always left me with a stuffed up nostril. The cleansing breath exercise is already part of my daily routine. I use it in conjunction with the legs up the wall pose in order to relieve stress and tension from my neck and

Positive airway pressure (PAP) is the standard treatment for patients with moderate-to-severe obstructive sleep apnea (OSA); a sleep-related breathing disorder (SRBD) characterized by episodic complete or partial upper airway occlusion during sleep.1 Over the past years, the relationship between SRBD and cardiac arrhythmias have been thoroughly investigated.2-7 Previous studies have shown that obstructive sleep apnea syndrome (OSAS) predisposes to clinically significant nocturnal impairment of the cardiac autonomic function and such impairment correlated with the severity of OSAS.8-11 The respiratory event-related cyclic hypoxemia and arousal characteristic of OSA causes dysregulation in the autonomic nervous system (ANS) in the form of enhanced sympathetic activity, such impairment is thought to be the substrate

The indication of tracheostomy includes (1) needed or long-term ventilator dependent due to acute respiratory failure (2) traumatic injury or neuromuscular disease requiring airway, or mechanical ventilator support or both(Cheung & Napolitano, 2014). However, we should also consider the patient's physiological needs, the patient's expectations, the characteristics of the disease, and the side effects and surgical risk posed by intubation vs. tracheostomy.