Percutaneous Transtracheal Ventilation
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Percutaneous Transtracheal Ventilation
Percutaneous transtracheal ventilation is the delivery of oxygen to the lungs through an over-the-needle catheter inserted through the skin into the trachea using a high pressure gas source is considered a form of conventional ventilation.{{cite journal, vauthors=Mace SE, Khan N , title=Needle cricothyrotomy. , journal=Emerg Med Clin North Am , year= 2008 , volume= 26 , issue= 4 , pages= 1085–101, xi , pmid=19059102 , doi=10.1016/j.emc.2008.09.004 , url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19059102 Percutaneous transtracheal ventilation may be mistaken for transtracheal jet ventilation, which is not considered conventional ventilation and refers to high-frequency ventilation; a low tidal volume Tidal volume (symbol VT or TV) is the volume of air moved into or out of the lungs during a normal breath. In a healthy, young human adult, tidal volume is approximately 500 ml per insp ...
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Cricothyroidotomy
A cricothyrotomy (also called cricothyroidotomy) is an incision made through the skin and cricothyroid membrane to establish a patent airway during certain life-threatening situations, such as airway obstruction by a foreign body, angioedema, or massive facial trauma. Cricothyrotomy is nearly always performed as a last resort in cases where other means of tracheal intubation are impossible or impractical. Compared with tracheotomy, cricothyrotomy is quicker and easier to perform, does not require manipulation of the cervical spine, and is associated with fewer complications. However, while cricothyrotomy may be life-saving in extreme circumstances, this technique is only intended to be a temporizing measure until a definitive airway can be established. Indications A cricothyrotomy is often used as an airway of last resort given the numerous other airway options available including standard tracheal intubation and rapid sequence induction which are the common means of establishing ...
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Mechanical Ventilation
Mechanical ventilation, assisted ventilation or intermittent mandatory ventilation (IMV), is the medical term for using a machine called a ventilator to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, with the main goal of helping the delivery of oxygen and removal of carbon dioxide. Mechanical ventilation is used for many reasons, including to protect the airway due to mechanical or neurologic cause, to ensure adequate oxygenation, or to remove excess carbon dioxide from the lungs. Various healthcare providers are involved with the use of mechanical ventilation and people who require ventilators are typically monitored in an intensive care unit. Mechanical ventilation is termed invasive if it involves an instrument to create an airway that is placed inside the trachea. This is done through an endotracheal tube or nasotracheal tube. For non-invasive ventilation in people who are conscious, face or nasal mask ...
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Transtracheal Jet Ventilation
Transtracheal jet ventilation refers to a type of high-frequency ventilation, low tidal volume ventilation provided via a laryngeal catheter by specialized ventilators that are usually only available in the operating room or intensive care unit. This procedure is occasionally employed in the operating room when a difficult airway is anticipated, such as Treacher Collins syndrome, Robin sequence, head and neck surgery with supraglottic or glottic obstruction. It is NOT recommended in emergencies if a person cannot be intubated or ventilated by other means.{{cite journal, last1=Duggan, first1=LV, last2=Ballantyne Scott, first2=B, last3=Law, first3=JA, last4=Morris, first4=IR, last5=Murphy, first5=MF, last6=Griesdale, first6=DE, title=Transtracheal jet ventilation in the 'can't intubate can't oxygenate' emergency: a systematic review, journal=British Journal of Anaesthesia, date=September 2016, volume=117 Suppl 1, pages=i28–i38, pmid=27566790, doi=10.1093/bja/aew192, doi-access=free ...
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High-frequency Ventilation
High-frequency ventilation is a type of mechanical ventilation which utilizes a respiratory rate greater than four times the normal value. (>150 (Vf) breaths per minute) and very small tidal volumes. High frequency ventilation is thought to reduce ventilator-associated lung injury (VALI), especially in the context of ARDS and acute lung injury. This is commonly referred to as lung protective ventilation. There are different types of high-frequency ventilation. Each type has its own unique advantages and disadvantages. The types of HFV are characterized by the delivery system and the type of exhalation phase. High-frequency ventilation may be used alone, or in combination with conventional mechanical ventilation. In general, those devices that need conventional mechanical ventilation do not produce the same lung protective effects as those that can operate without tidal breathing. Specifications and capabilities will vary depending on the device manufacturer. Physiology With conve ...
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Tidal Volume
Tidal volume (symbol VT or TV) is the volume of air moved into or out of the lungs during a normal breath. In a healthy, young human adult, tidal volume is approximately 500 ml per inspiration or 7 ml/kg of body mass. Mechanical ventilation Tidal volume plays a significant role during mechanical ventilation to ensure adequate ventilation without causing trauma to the lungs. Tidal volume is measured in milliliters and ventilation volumes are estimated based on a patient's ideal body mass. Measurement of tidal volume can be affected (usually overestimated) by leaks in the breathing circuit or the introduction of additional gas, for example during the introduction of nebulized drugs. Ventilator-induced lung injury such as Acute lung injury (ALI) /Acute Respiratory Distress Syndrome (ARDS) can be caused by ventilation with very large tidal volumes in normal lungs, as well as ventilation with moderate or small volumes in previously injured lungs, and research shows that t ...
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Mechanical Ventilation
Mechanical ventilation, assisted ventilation or intermittent mandatory ventilation (IMV), is the medical term for using a machine called a ventilator to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, with the main goal of helping the delivery of oxygen and removal of carbon dioxide. Mechanical ventilation is used for many reasons, including to protect the airway due to mechanical or neurologic cause, to ensure adequate oxygenation, or to remove excess carbon dioxide from the lungs. Various healthcare providers are involved with the use of mechanical ventilation and people who require ventilators are typically monitored in an intensive care unit. Mechanical ventilation is termed invasive if it involves an instrument to create an airway that is placed inside the trachea. This is done through an endotracheal tube or nasotracheal tube. For non-invasive ventilation in people who are conscious, face or nasal mask ...
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Respiratory Therapy
A respiratory therapist is a specialized healthcare professional, healthcare practitioner trained in Intensive care medicine, critical care and cardio-pulmonary medicine in order to work therapeutically with people who have acute critical conditions, Cardiovascular disease, cardiac and Respiratory disease, pulmonary disease. Respiratory therapists graduate from a college or university with a degree in respiratory therapy and have passed a national board certifying examination. The NBRC (National Board for Respiratory Care) is responsible for credentialing as a CRT (Certified Respiratory Therapist, certified respiratory therapist), or RRT (Registered Respiratory Therapist, registered respiratory therapist), The specialty certifications of respiratory therapy include: CPFT and RPFT (Certified or Registered Pulmonary Function Technologist), ACCS (Adult Critical Care Specialist), NPS (Neonatal/Pediatric Specialist), and SDS (Sleep disorder specialist, Sleep Disorder Specialist). Re ...
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Intensive Care Medicine
Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes providing life support, invasive monitoring techniques, resuscitation, and end-of-life care. Doctors in this specialty are often called intensive care physicians, critical care physicians or intensivists. Intensive care relies on multidisciplinary teams composed of many different health professionals. Such teams often include doctors, nurses, physical therapists, respiratory therapists, and pharmacists, among others. They usually work together in intensive care units (ICUs) within a hospital. Scope Patients are admitted to the intensive care unit if their medical needs are greater than what the general hospital ward can provide. Indications for the ICU include blood pressure support for cardiovascular instability ( hypertension/hypote ...
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