Morbid Obesity And Its Effects

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

Jane’s asthma was acute severe. Initially to alleviate some of Jane’s breathlessness she was sat up right in the bed and supported with pillows to improve air entry. Due to her low oxygen saturations she was placed on 40% oxygen via Hudson mask (BTS 2006), as Jane was mouth breathing the mask was the appropriate device to use to ensure adequate oxygenation (Walsh 2002). According to Inwald et al (2001) hypoxemia is frequently a primary cause in numerous asthma related deaths. By administering oxygen promptly, for acute severe asthma, serious hypoxemia

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

Although different kinds of tubes are placed in a patient at the bedside every day, it is important to remember the complications that can arise if a tube in not placed correctly or in the right place. Health care workers recognize this risk and take steps to ensure proper insertion. This study recommends that health care workers use at least two bedside methods to verify placement. These include, pH, visual signs of aspirate, patient’s respiratory condition, monitoring the tube every four hours, marking the exit location of the tube and capnography. These methods have all been backed by research to show their validity in determining tube placement. Although included on the list, the auscultation of an air bolus is not included in one of the recommended bedside tests. Although it is widely used in practice, the article states that “no evidence indicates that the auscultatory method is useful for determining the location” ( Methany 2016). If heath care providers relied on the auscultation method as one of the recommended bedside tests, the tube could be in the wrong place in the body or in the lungs. If feedings or medications were given through the tube in the wrong place it could lead to extreme complications or even death. This article notes x ray as, again, the gold standard for ensuring placement. This article along with several

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

One of the most important things to maintain a trauma patients airway is ensuring that you have adequate help around (Stephens, 2011). This is important because there are many different tasks that must be delegated in maintaining this persons airway. Some of these processes include opening the airway, suctioning the airway, inserting the proper adjunct, and maintaining

Patient outcome consisted of performing 10 deep breaths per hour. We have reviewed details that were difficult for the patient to remember, such as breathing out before placing the lips on the mouthpiece, and holding breath for 3 to 5 seconds at the top of each inhalation. With empathy, I provided understanding that being hospitalized is never easy due to sensory overload, pain and lack of privacy. Additionally, we have discussed the basic pathophysiology of lung inflammation and what it can do to a person. So overall, the outcome included enhanced disease knowledge with effective use of incentive spirometer.

Per OJIN, expected obesity-related issues are as those such as “skin, pulmonary, resuscitation, drug absorption, intravenous access, and mobility”. The above described anticipated issues impact the nursing profession and it’s administration of holistic care because of unexpected events or lack of knowledge caring for these issues.

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.

Managing complex ventilator patients require critical thinking to solve problems pertaining to ventilator issues. Even though I am a certified ventilator paramedic, ventilator management is managed an respiratory therapist. Having the ventilator certification was useful in which I was able to apply my knowledge to

Tracheostomy is commonly performed procedure on critically ill patients who require prolonged mechanical ventilation. Obesity has previously been considered a relative contraindication to performing tracheostomy due to increased risk of periprocedural complications. Over the years, advancements have been made with the use of flexible and rigid bronchoscopy to assist in percutaneous dilatational tracheostomy. Recent studies have evaluated the safety of performing tracheostomy in obese patients utilizing these different techniques. Despite the developments, there are still major risk factors that need to be taken into consideration in the obese population prior to tracheostomy placement. The indications, optimal timing, techniques (both percutaneous

Patients presenting to the operating theatre for emergency surgery often require complex action plans. Minimal screening or preparation time and the underlying illness pathology contribute to their complexity. The combination of Mr Knight’s underlying hypertension, diabetes and obesity with his suspected bowel obstruction put him into the complex patient category. This anaesthetic plan will discuss Mr Knight’s comorbidities and a selection of anaesthetic techniques. Techniques discussed will focus on a number of difficult airway techniques, both invasive and non-invasive monitoring methods, the importance of fluid management, camponography, planning for discharge to the post anaesthetic care unit (PACU) and documentation.

The wide use of capnometry across hospital settings has evolved to be an industrial tool for identifying potential breathing complications among patients (hyperventilation, hypoventilation, or apnea). ETCO2 is the only non-invasive monitor that is used in “real time” providing instant indication to physicians, paramedics and other healthcare professionals alike. Registered nurses have adapted to use this device for determining if a nasogastric tube has been placed appropriately-- in the esophagus or the trachea. So, one may ask what is capnometry? It is the maximal concentration of carbon dioxide at the end of each exhaled breath illustrated in wavelength form on a x and y axis grid. The waveform

Background: Airway assessment is one of the most predictable ways to identify the difficulties of the airway, especially if the patient has to do a surgery and have to be intubated. We can predict by airway examination the difficulties of the patient’s airway track, and put many plans regarding how to do intubation safely. The target of patient’s airway assessment is to detect any existing deformities in the airway and face in order to make a suitable plan to secure the airway successfully. Between June 2002 and September 2003, an observational study conducted in the emergency department of UK teaching hospital, 156 patients who involved in the study and undertook airway assessment based on L-E-M-O-N method were all intubated successfully. The study concluded that “Use of this score would encourage airway managers to conduct a thorough systematic evaluation of the airway and to readily anticipate problems in its management.

Tracheostomys may be required for long term control of excessive bronchial secretions, particularly in those with reduced consciousness or to maintain an