Management of tracheostomy tubes: A Minute of Meducation

Management of tracheostomy tube: 

A Minute of Meducation:

Tracheostomy tube obstruction with mucous plugging is common.

How to Manage it:

It is best treated with preoxygenation (as suctioning may cause transient hypoxia) and then placing of sterile saline into the trachea and suctioning through large flexible catheters through the inner cannula. If this does not succeed, remove the inner cannula and clean with hydrogen peroxide and rinse with water. Sometimes, the entire tracheostomy tube needs to be removed and cleaned. Tracheostomy tubes less than 7 days in maturation should be manipulated only by otolaryngology surgeons. Remember 'Pediatric' tracheostomies do not have inner cannulas.

Emergency Management of Agitated Patient

Emergency Management of Agitated Patient

Managing spontaneous ICH the Rosenalli way

Managing spontaneous ICH,

( the Rosen Tintinalli way )

HEART Pathway for low risk chest Pain

HEART Pathway for low risk chest Pain

Glasgow Coma Scale

Here is the traditional GCS

RSI/ Airway Management Drugs

Rapid Sequence Incubation

Airway Management Drugs are listed below

WHAT IS SHOCK- A Simplified approach, iSHOCK

iSHOCK

Condition of severe impairment of tissue perfusion leading to cellular injury and dysfunction. Rapid recognition and treatment are essential to prevent irreversible organ damage and death

Common CAUSES

Oligemic shock

Hemorrhage

Volume depletion (e.g., vomiting, diarrhea, diuretic overusage, ketoacidosis)

Internal sequestration (ascites, pancreatitis, intestinal obstruction)

Cardiogenic shock

Myopathic (acute MI, dilated cardiomyopathy)

Mechanical (acute mitral regurgitation, ventricular septal defect, severe aortic stenosis)

Arrhythmic

Extracardiac obstructive shock

Pericardial tamponade

Massive pulmonary embolism

Tension pneumothorax

Distributive shock (profound decrease in systemic vascular tone)

CLINICAL FEATURES:

Hypotension (mean arterial bp <60 mmHg), tachycardia, tachypnea, pallor, restlessness, and altered sensorium.

Signs of intense peripheral vasoconstriction, with weak pulses and cold clammy extremities. In distributive (e.g., septic) shock, vasodilatation predominates and extremities are warm.

Oliguria (<20 mL/h) and metabolic acidosis common.

Acute lung injury and acute respiratory distress syndrome with noncardiogenic pulmonary edema, hypoxemia, and diffuse pulmonary infiltrates.

EXAMINATION: