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Prevention of infective complications of penetrating injuries to the head


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Published 01 January 2000
Reads 619
Language English
Document size 6 MB
l 3 Suppl 1March 1999
ye care performed
atient developed loped conjunctivi ropriate measures atients (15%) had itive microbiologi
f an eye care stan surface complica  inthis group of
e performed in 13 ere no complica m fee and charge nd the anesthesia eostomy tube cost, ot included in the  drapesand tra tracheostomy and min respectively;  widelydivergent
al procedure, total low. Cost savings 2 $36231.13
gement of endo  ICU.During the with acute endo bronchoscopy. All f epinephrine and
f the endotracheal tube/cuff: 0 patients n puncture of the trachea: 0 patients ia: 0 patients
T is a simple bedside procedure with a low com he combination with the trachlight device gives  forbetter identification of the anatomy of the as the correct placement of the endotracheal tube endotracheal ring. These contribute to better con and accurate tracheal puncture and cannulation.
, Worthley Lig, Gilligan JE, Thomas PD, Myburg le percutaneous tracheostomy technique.Surg
cutive cases of the translaryngeal
90%), three cases of hypotension, two related to technique and one following traumatic intubation. ur episodes of accidental decannulation and one ubcutaneous emphysema. There was one case of loss (100–250ml). There was one episode of loss patient who was difficult to intubate (Gr. III). We f wound infection associated with preexistent sys ia. Total duration of the tracheostomy ranged from l closure of the stoma took a mean of 4 days (range resultant scar was minimal.
is pure dilatational and bronchoscopically visu s easy to perform with training. It is worthy of con atients with coagulation abnormalities. We feel it ntrol over the airway than other available tech h there is a definite risk of decannulation while e cannula over the obturator. The overall morbidity e is low.
t al.: Crit Care1997,1 (suppl 1):S44.
be by nasotracheal intubation
Height WBDLT Durat. Diagnosis (cm)(kg) size(h) Post upper lobectomy155.5 445.5 65 Aspiration pneumonia145 355.5 120 Lung trauma143 605.5 94 Aspiration pneumonia153 59.86.0 100 Atelectasis 15050 5.550 Atelectasis, DIC157.8 42 6.025
et o s:rty patents requr ngor >were stue . Pts received humidification via a HH, HH + HWC (Fisher & Paykel), and AHME in random sequence for 24h each. All devices were set to deliver 37C at the proximal airway. During each period of ventilation, the following were measured; airway temperature, min and max body temperature, number of suction ing attempts, volume of secretions, consistency of secretions, number and volume of saline instilled, water usage, condensate, ventilator settings, minute volume, number of circuit disconnec tions. Water usage was measured by weighing the water bag before and after 24h use. Consistency of secretions were judged as thin, moderate, or thick as previously described (Suzukawa: Respir Care1989,34:976). Condensate was measured by emptying fluid into a graduated container and sputum volume measured by collecting secretions in a Luken’s trap. Airway temperature was measured at the ET tube using a rapid response thermistor. Resis tance of the AHME was measured before and after use.
tion The ice V’e aps. ani the not the
ated ncy, ater rent not. . C)
P19 Modellingthe effect of ambient oxygen fraction on hypoxaemia during apnoea JG Hardman
Crit Care1999,3 (suppl 1):P19
50 aO2with a mbient o xygen fraction : Hypoxaemia during apnoeic oxygenation complicates tests fo a)21% 50% brainstem death and exposes the patient’s organs to the risk o 40 c)80% anoxic damage. This study investigates the effect on hypoxaemid)100% aO2orPaCO2 of varying the ambient oxygen fraction during apnoea.30 aCO2 (kPa) 20 Methods and results:The Nottingham Physiology Simulator is validated simulation of advanced, iterative physiological models 10 [1]. The model was set up as a 70 kg adult with normal physiologi d a c cal values other than: pulmonary venous admixture 20%, alveola 0 deadspace fraction 20% of tidal volume and functional residual -5 0 5 1015 20 25 30 35 40 45 50 55 60 capacity 2l. The patient’s lungs were ventilated with 100% Time (minutes)