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Related Concept Videos

Respiratory System Abnormal Finding II: Palpation and Auscultation01:31

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In assessing respiratory abnormalities, palpation and auscultation are critical tools for detecting and interpreting various pathophysiological changes. These techniques provide insight into underlying disorders by evaluating tactile sensations and sounds produced by the respiratory system.
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Physical Assessment of the Respiratory Tract IV: Auscultation01:28

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Auscultation is a crucial component of the physical assessment of the respiratory tract. It offers valuable insights into airflow through the bronchial tree and potential lung obstructions. This process involves careful listening to breath, voice, and adventitious sounds, which can reveal a wealth of information about a patient's respiratory health.
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Assessment of the Cardiovascular System IV: Auscultation01:25

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Cardiac auscultation is a clinical skill used to assess heart function and detect abnormalities. It involves listening to heart sounds at specific anatomical locations through a stethoscope.
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Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
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Cardiovascular System Abnormal Findings II: Auscultation01:25

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Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
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Assessment of Ventilation II: Respiratory Depth and Rhythm01:29

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Respiratory Depth
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Point-of-Care Ultrasound: A Review of Ultrasound Parameters for Predicting Difficult Airways
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Above cuff vocalisation (ACV): A scoping review.

Antonija Petosic1,2, Marit F Viravong3, Anna M Martin4

  • 1Division of Emergencies and Critical care, Department of Postoperative and Intensive care, Oslo University Hospital, Oslo, Norway.

Acta Anaesthesiologica Scandinavica
|September 13, 2020
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Summary
This summary is machine-generated.

Above cuff vocalisation (ACV) helps intensive care patients with cuffed tracheostomies to speak and improves their quality of life. While generally safe, some minor and two serious adverse events were reported.

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Area of Science:

  • Medical research
  • Intensive care medicine
  • Respiratory therapy

Background:

  • Patients in intensive care units (ICUs) often lose their ability to speak due to mechanical ventilation and tracheostomy tubes.
  • Cuffed tracheostomies, while necessary for airway protection, prevent airflow for speech.
  • Effective communication is crucial for patient well-being and care in the ICU.

Purpose of the Study:

  • To conduct a scoping review on the safety and effectiveness of above cuff vocalisation (ACV) in patients with cuffed tracheostomies.
  • To assess the impact of ACV on speech, voice-related quality of life (V-RQOL), and overall quality of life (QOL) in mechanically ventilated patients.
  • To identify any complications or adverse events associated with ACV.

Main Methods:

  • A systematic scoping review was performed.
  • Searches were conducted in Ovid Medline, Cochrane Library, and Embase databases in May 2020.
  • Included studies assessed speech, QOL, or safety outcomes in patients using ACV.

Main Results:

  • 17 studies (15 observational, 2 RCTs) involving 231 patients were included.
  • ACV enabled speech in 88% of patients (moderate evidence).
  • Voice-related QOL and QOL in mechanically ventilated patients showed improvement (very low evidence).
  • Minor complications occurred in 27% of cases; two serious adverse events (subcutaneous emphysema, tracheal distension) were reported (low/very low evidence).

Conclusions:

  • Above cuff vocalisation (ACV) is effective in facilitating communication for patients with cuffed tracheostomies.
  • Evidence for improved quality of life outcomes is limited by very low-quality data.
  • While ACV is generally safe, potential complications require monitoring and careful management.