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Related Concept Videos

Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

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A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
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Tracheostomy Decannulation01:21

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Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
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Tracheostomy Care II: Procedure01:25

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Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
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Social Exchange Theory02:06

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We have discussed why we form relationships, what attracts us to others, and different types of love. But what determines whether we are satisfied with and stay in a relationship? One theory that provides an explanation is social exchange theory. According to social exchange theory, we act as naïve economists in keeping a tally of the ratio of costs and benefits of forming and maintaining a relationship with others (Rusbult & Van Lange, 2003).
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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Gas exchange, the intake of molecular oxygen (O2) from the environment and the outflow of carbon dioxide (CO2) into the environment, is necessary for cellular function. Gas exchange during respiration occurs largely via the movement of gas molecules along pressure gradients. Gas travels from areas of higher partial pressure to areas of lower partial pressure. In mammals, gas exchange occurs in the alveoli of the lungs, which are adjacent to capillaries and share a membrane with them.
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Percutaneous Dilatational Tracheostomy Using Tube Exchanger.

Ohad Ronen1,2, Alexander Gurevich3, Shimon Ivry3

  • 1From the Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel.

Anesthesia and Analgesia
|March 16, 2018
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Summary

A modified percutaneous dilatational tracheostomy technique using a tube exchanger is effective and safe. This method offers rapid reintroduction of the endotracheal tube, minimizing complications during the procedure.

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Area of Science:

  • Medical Procedures
  • Surgical Techniques
  • Respiratory Medicine

Background:

  • Percutaneous dilatational tracheostomy (PDT) is a common procedure for airway management.
  • Existing PDT techniques may have limitations or require specialized equipment.
  • Enhancing the safety and efficacy of PDT is crucial for patient outcomes.

Purpose of the Study:

  • To describe and evaluate a modified percutaneous dilatational tracheostomy technique.
  • To assess the effectiveness and failure rate of this modified PDT approach.
  • To highlight the safety benefits, including rapid endotracheal tube reintroduction.

Main Methods:

  • A modified PDT technique utilizing a 15F tube exchanger or Eschmann catheter was employed.
  • A retrospective review of 1180 procedures performed with this technique was conducted.
  • Data on procedure effectiveness, failure rate, and complications were analyzed.

Main Results:

  • The modified PDT technique demonstrated high effectiveness with a low failure rate of 0.25% (3 out of 1180 patients).
  • The technique allows for rapid reintroduction of the endotracheal tube using the exchange catheter in cases of accidental extubation.
  • No additional specialized equipment, such as a bronchoscope, is required for this method.

Conclusions:

  • The modified percutaneous dilatational tracheostomy technique using a tube exchanger is effective and safe.
  • The technique offers an added safety feature for managing accidental extubation during the procedure.
  • Further prospective studies are recommended to comprehensively define the complication rate.