Summary: Pumpless Extracorporeal Lung Assist

Regarding Extracorporeal shockwave therapy 1X3 - Left Shoulder, CA MTUS does not specifically address this issue. ACOEM and ODG recommended shockwave therapy for calcifying tendinitis but not for other shoulder disorders. This is a chronic pain patient with a 2014 date of injury. The patient has significant left shoulder pain. However, the latest progress note indicated that psychical exam revealed full ROM and no tenderness to palpation over the shoulder joint. In addition the guidelines do not recommend shockwave therapy for sprain/strains or laceration of the shoulder. Furthermore, the latest progress report discussed about continued shockwave treatment. It is unclear, if shockwave therapy has been provided before. Medical necessity has

A.W., a 52-year-old woman disabled from severe emphysema, was walking at a mall when she suddenly grabbed her right side and gasped, “Oh, something just popped.” A.W. whispered to her walking companion, “I can’t get any air.” Her companion yelled for someone to call 911 and helped her to the nearest bench. By the time the rescue unit arrived, A.W. was stuporous and in severe respiratory distress. She was intubated, an IV of lactated Ringer’s (LR) to KVO (keep vein open) was started, and she was transported to the nearest emergency department (ED).

This time-cycled release phase allow for CO2 removal and keep the alveoli inflated at the “inspiratory pressure for most of the respiratory cycle”, allowing for “a higher mean airway pressure at lower peak airway pressures. APRV produces similar or improved oxygenation with lower peak airway pressures with no significant hemodynamic effects compared with alternative modes of ventilation in neonatal, pediatric, and adult populations.” (Kenny, et al., 2011) The Respiratory Care Journal (2012) stated that “the primary goals of this mode were to

The three major life-breathing concerns for a patient is a disruption of the airway, breathing, and circulation. When a patient goes into cardiac arrest due to pre-existing conditions or trauma, an EMT will initiate the steps of cardiopulmonary resuscitation (CPR) and hopefully using an available automated external defibrillator (AED). However, some patients due to having a terminal illness, age, or personal choice does not want to be resuscitated or have

ARDS is acute respiratory failure with persistent hypoxemia, decreased pulmonary compliance, dyspnea, noncardiac-associated pulmonary edema, and dense pulmonary infiltrates on the chest x-ray. The main site of injury within the lung is the alveolar-capillary membrane

Continuous Positive Airway Pressure or CPAP as it is known, uses forced air to keep a patients airway open. It has common uses that most people are familiar with such as sleep apnea. But it also used in emergency and hospitals routinely to treat sicknesses such as congestive heart failure. In this essay I will give a brief history on CPAP, a basic overview of its anatomy and the some of the many uses of CPAP and health benefits.

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

Pulmonary embolectomy. Rarely used, this is surgery done to remove a PE. It is done only in severe cases when the PE is very large, the patient can not get anticoagulation and/or thrombolytic therapy due to other medical problems or the patient has not responded well to those treatments, or their condition is

The American Heart Association Paediatric Advanced Life Support (PALS) aims at aiding the paediatric healthcare specialists in developing the knowledge and skills necessary to efficiently and effectively manage seriously ill infants and children. All these steps assure improved outcomes and an efficient pediatric first aid.

ESWL or Extracorporeal Shock Wave Lithotripsy is a non-invasive treatment of kidney stones (urinary calculosis) that uses an acoustic pulse to break kidney stones into small pieces that can more easily travel through the urinary tract and pass from the body. How does this work?

Extracorporeal Membrane Oxygenation is a medical modality that provides life support for patients experiencing pulmonary failure, cardiac failure, or both. ECMO is able to maintain oxygenation and perfusion to the body until the native lungs or heart function can be restored. According to Maj (1990) “ECMO is a long term heart and lung bypass technique that has been successfully used since 1975.” ECMO can be divided into two categories; Veno-venous ECMO (VV ECMO) which supports the lungs by oxygenating the blood and returning the oxygenated blood to heart. This

The artificial lung is on a road to becoming the greatest thing in medical history. Over 200 million people suffer from respiratory diseases, 350,000 people a year die from lung disease and 150,000 more people require medical care for this disease. Individuals that suffer with respiratory diseases often need a caretaker to look after them if they cannot do basic things like use the restroom without gasping for air to breath or drive to the store by themselves. The artificial lung allows people to breath normally just like the lungs humans genetically possess. Also, this technology allows people to do everyday things that they could not do before. The artificial lung is not a pertinent solution but, this gives people the opportunity and gift of more time to live as they wait for a donor lungs become available. This will positively impact society as it dramatically reduces the lung disease death rate and saves countless lives.

Approximately in 1998 while working in CT-ICU a patient coded and needed the insertions of an intra-aortic balloon pump (IABP), which is a cardiac assist device. These pumps where stored in the cardiac catheterization lab. The supervisor along with a few others went to the unit to get the pump, on return the actual balloon itself was not brought back, which constituted another trip and further delay. The course of events to have to acquire different parts for the pump, caused delay of care. After more than one hour of resuscitative attempt, the patient succumbed and was pronounced. I was relief charge and the incident had to be written up with specifics as to what caused the delays. The physician along with the nurses had the policy changed

There comes a point when a critically ill patient can no longer maintain the basic oxygenation and the removal of carbon dioxide of their blood and tissues. When that point is reached the job can be performed for the patient through the use if Extracorporeal Membrane Oxygenation. This treatment was developed in the 1970’s and used primarily in children due to the high rate of complications see in adults (Kulkarni, Tejaswini & Sharma, Nirmal & Diaz-Guzman, Enrique, 2016, p. 373). The following will discuss what ECMO is, indications for the use of ECMO, and the potential complications inherent in the use of ECMO.

We noticed that most deaths in ARDS are related to sepsis or multiorgan failure rather than to a primary pulmonary cause, although the recent success of mechanical