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Related Concept Videos

Endotracheal Intubation II: Nursing Management01:17

Endotracheal Intubation II: Nursing Management

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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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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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Tonsillitis II: Management01:26

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This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
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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 Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

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A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
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Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

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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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Intensive Care Unit Transfer in Patients With Deep Neck Infections.

Yu-Cheng Hung1, Chia-Ying Ho1,2, Kai-Chieh Chan1,3

  • 1School of Medicine, Chang Gung University, Taoyuan, Taiwan.

Ear, Nose, & Throat Journal
|September 12, 2024
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Older patients with high C-reactive protein (CRP) levels and mediastinitis are more likely to require intensive care unit (ICU) admission for deep neck infections (DNI). This leads to longer hospital stays and increased tracheostomy rates.

Keywords:
C-reactive proteindeep neck infectionelder ageintensive care unitmediastinitis

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Area of Science:

  • Otolaryngology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Deep neck infection (DNI) is a serious condition that can compromise the airway.
  • Patients with severe DNI may require intensive care unit (ICU) admission.
  • Risk factors for ICU admission in DNI patients are not well-established.

Purpose of the Study:

  • To identify the risk factors associated with ICU transfer in patients diagnosed with DNI.
  • To analyze clinical and laboratory parameters predicting the need for intensive care in DNI cases.

Main Methods:

  • Retrospective analysis of 350 adult DNI patients from October 2018 to October 2023.
  • Evaluation of clinical and laboratory data, including age, C-reactive protein (CRP), and blood glucose levels.
  • Univariate and multivariate logistic regression analyses to determine independent risk factors for ICU transfer.

Main Results:

  • Older age, elevated CRP levels, and mediastinitis were identified as independent risk factors for ICU transfer.
  • Patients transferred to the ICU experienced significantly longer hospital stays and higher rates of tracheostomy.
  • Involvement of three or more deep neck spaces was a significant risk factor in univariate analysis.

Conclusions:

  • Elderly patients, those with high CRP levels, and mediastinitis are at increased risk of ICU admission for DNI.
  • ICU admission for DNI is associated with prolonged hospitalization and a greater need for tracheostomy.
  • Clinical assessment should incorporate these factors to guide timely ICU transfer and airway management decisions.