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Related Concept Videos

Endotracheal Intubation I: Procedure01:15

Endotracheal Intubation I: Procedure

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Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
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Endotracheal Intubation II: Nursing Management01:17

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Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
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Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen01:16

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Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
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Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Oxygen Delivering System III: Tracheostomy and T-piece01:23

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Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
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Endotracheal Tube Extubation01:24

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Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
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Decreasing delivery room intubations: A quality improvement project.

Luke Jardine1,2, Karina Bates1, Amanda Bates1

  • 1Neonatal Critical Care Unit, Mater Mothers Hospital, Brisbane, Queensland, Australia.

Journal of Paediatrics and Child Health
|August 27, 2021
PubMed
Summary

Delivery room intubation for preterm infants was significantly reduced by implementing bubble continuous positive airway pressure. This quality improvement initiative demonstrated a safer approach to initial resuscitation for premature babies.

Keywords:
delivery roomintubationpreterm infantquality improvement

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Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Quality Improvement Science

Background:

  • Delivery room intubation rates for infants under 32 weeks postmenstrual age (PMA) were high (51% in 2017).
  • Delivery room intubation in preterm infants is linked to an increased risk of bronchopulmonary dysplasia.

Purpose of the Study:

  • To decrease the rate of delivery room intubation for infants born less than 32 weeks PMA.
  • To evaluate the impact of a quality improvement project on intubation rates and associated outcomes.

Main Methods:

  • A quality improvement project utilizing the evidence-based practice for improving quality framework and Plan-Do-Study-Act cycles.
  • Implementation of bubble continuous positive airway pressure (bCPAP) for initial resuscitation in the delivery room.

Main Results:

  • Delivery room intubation rates decreased from 48% (cohort 1) to 37.2% (cohort 2) and further to 28.2% (cohort 3).
  • Significant improvements in admission temperatures and a decrease in mortality were observed between cohort 1 and cohort 2.
  • No significant changes in oxygen discharge rates or adverse outcomes were noted.

Conclusions:

  • The quality improvement project successfully reduced delivery room intubation rates in extremely preterm infants.
  • The introduction of bCPAP for initial resuscitation was safe and did not lead to adverse outcomes.