Assessing Patient Readiness for Extubation
Assessing Patient Readiness for Extubation
Posts
ASPIRATION
ASPIRATION Risk Factors of Aspiration Patient: Inadequate fasting Delayed gastric emptying Incompetent Lower Oesophageal Sphincter (Emergency, Pregnancy, Diabetes,
How to Master Tracheal Intubation
According to the 2000 AHA ACLS Guidelines, tracheal intubation should only be attempted “by healthcare providers experienced in performing this skill”, and expand further by stating that “ALS providers unable to obtain regular field experience… should use alternative, noninvasive techniques for airway management”. This year ILCOR examined evidence to determine if one airway is superior to another in terms of survival and neurologic outcome in cardiac arrest. According to the evidence summary “there is inadequate evidence to show a difference in survival or favorable neurologic outcome”, and recommend that the “choice of bag-mask device versus advanced airway insertion, then, will be determined by the skill and experience of the provider”. The clinician must have sufficient initial and continuing education for whatever airway they choose, and must effectively do so while limiting interruptions in quality CPR. Some EMS services have demonstrated a 99% success rate for endotrach...
FAILED INTUBATION
Continue BMV between attempts, call for help and remember each attempt mandates a different approach. 1. If SpO2 permits allow a maximum of 3 attempts. 2. For direct or Macintosh videolaryngoscopy optimize technique, ELM, head position and consider using adjuncts.
Anticipated difficult tracheal intubation: Canadian Guidelines.
The following discussion and accompanying flow diagram attempt to identify the relevant factors that must be weighed when creating a patient-specific airway strategy. Neither discussion nor flow diagram is meant to be prescriptive. Many factors impact the decision, including patient cooperation, consent, and the clinician’s expertise.
LEMON Airways Assessment Method.
The tool developed to determine which patients might pose airway management difficulties is the LEMON method.
The Two-Bag Test. Checking Anaesthetic Equipment Guideline.
Guidelines on checking anaesthetic equipment have been published by the Association of Anaesthetists of Great Britain and Ireland (AAGBI), and amongst others, the American Society of Anesthesiologists, the Australian and New Zealand College of Anaesthetists and the World Federation of Societies of Anesthesiologists.