Medicina intensiva
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The clinical value of routine chest X-rays in critical care has been questioned, but has not been studied in the trauma environment to date. The objective of this study was to identify easy to use clinical predictors of utility in this setting. ⋯ Based on the results obtained, the risk of not identifying dangerous conditions by restricting routine chest X-rays prescription to the described conditions is low. Observing this policy would probably mean substantial savings and a reduction in radiation exposure.
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Boussignac valve is a new resource to consider in acute pulmonary edema cardiogenic management. As it generates positive airways pressure continuous (CPAP) and it is very simple to use, its use is being extended to emergency, urgency and hospitalization ward services. This valve is a small tube placed over the interface expiratory port. ⋯ These characteristics make it possible to extend it use in those patients who, in extreme conditions, need diagnostic tests that could deteriorate their respiratory situation, such as endoscopy procedures. We report three critical patients who received CPAP with a Boussignac valve connected to an orofacial interface, while performing two fibrobronchoscopies and one upper digestive tract endoscopy. All finished successfully and none of them need orotracheal intubation.