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Category: Critical Care Nursing Risks associated with emergent intubation in the critically ill include hypoxemia, hemodynamic instability, cardiac arrest and death, underlining t...
Category: Critical Care Nursing Rapid-sequence intubation (RSI) is the standard of care in most emergency airway management settings because of its high rate of success. The goal...
Category: Critical Care Nursing Acute respiratory insufficiency occurs when the lungs no longer meet the metabolic demands of the body, which by tradition is divided into two type...
Category: Critical Care Nursing Reported complication rates from tracheal intubation in the critically ill patient population can range from 4.2% to 22% and remain unacceptably hi...
Category: Critical Care Nursing The first reported in children and then recognized also in adults, prolonged high-dose propofol (>100 μg/kg/min) is associated with the “prop...
Category: Critical Care Nursing In rapid-sequence intubation, the initial induction agent doses should be reduced by 25%–50% in the elderly and in patients with hypotension, hyp...
Category: Critical Care Nursing Hemodynamic instability is an predictor of death after intubation, underscoring the importance of an individualized approach to high-risk patients,...
The ICU Before Sunrise The intensive care unit (ICU) was crowded before sunrise, again. After 40 years in medicine, I am not sure what “full” even means anymore. Every ICU now feel...
Category: Critical Care Nursing Rapid-sequence intubation has an inherent delay of 45-90 seconds between medication administration and laryngoscopy. In patients with refractory hy...
Category: Critical Care Nursing Critically ill patients are at risk for periprocedural hypotension, which can lead to cardiac arrest. Hypotension during intubation is common, ofte...
Category: Critical Care Nursing During intubation, vasopressors should be used for periprocedural hypotension. Although a fluid bolus before induction has been shown to reduce the...
Category: Critical Care Nursing Critically ill patients run higher risks of hypoxemia. Preoxygenation is limited by functional residual capacity and the ability to denitrogenate t...
Dr. Corl’s narrative is wrenching, and the case he describes deserves the somber consideration that any preventable death in the intensive care unit (ICU) demands. His indictment o...
Category: Critical Care Nursing With tracheal intubation, decompensated cardiopulmonary disease and shunt physiology make preoxygenation more difficult in the critically ill, shor...
Category: Critical Care Nursing With intubation, optimal patient positioning is important to maximize the success of both preoxygenation and laryngoscopy attempts. Upright positio...
Category: Critical Care Nursing Failing respiratory muscles, pain preventing effective breathing, increased abdominal pressures and agents that suppress respiratory drive - all de...
Category: Critical Care Nursing Avoiding hypoxemia is essential to preserve safe conditions during intubation. If oxygen saturation drops, the first rescue maneuver is the BMV tec...
A patient discharged from the ICU on a ventilator may no longer fit the traditional image of “critical care,” but that does not mean the medical complexity disappears. In post-acut...
Category: Critical Care Nursing In intubation, caution should be taken in the catecholamine-depleted patient, as Ketamine can act as a negative inotrope. Although Ketamine can rel...
Category: Critical Care Nursing In rapid-sequence intubation, Ketamine increases heart rate, blood pressure and cardiac output and has been shown to provide similar intubating con...
HN Summary • A major international study led by Scarborough Health Network found that CPAP, high-flow nasal cannula and bilevel non-invasive ventilation can reduce the need for inv...
Category: Critical Care Nursing Infusion of bicarbonate can lead to a variety of problems in patients with acidosis, including fluid overload, hypernatremia and metabolic alkalosi...
Category: Critical Care Nursing The first therapeutic maneuver in patients with a metabolic alkalosis is to replace any volume deficit with normal saline and correct electrolyte d...
Category: Critical Care Nursing Severe metabolic acidosis results in myocardial depression with a reduction in cardiac output, blood pressure and decreased hepatic and renal blood...
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