Articles: intubation.
-
The human larynx is complex and serves multiple functions. Unfortunately, endotracheal tubes do not reproduce all these functions. They serve well as air passages but cannot do so without damaging the mucosa of the posterior larynx. ⋯ It is hoped that this reduction in complications will carry over into the chronic care setting as such monitoring becomes the standard after intubations. Compared with malposition of the tube, most of the other complications of intubation are minor. However, knowledge of the various complications can ensure avoidance of many and early detection and correction of others.
-
Intensive care nursing · Sep 1991
ReviewA review of communication with intubated patients and those with tracheostomies within an intensive care environment.
A major aspect of nursing care within intensive care environments is communication. If nursing communication with patients is to be both effective and therapeutic nurses need to understand the principles of communication and identify the purposes of nurse-patient interactions. The main purpose of this article is to review and examine normal communication channels and the actual and potential barriers to communication between nurses and patients who are intubated or have tracheostomies. The assessment of these patients' needs for communication, planning, implementation and evaluation of nursing to meet them are discussed, and also implications for the future.
-
Double-lumen endotracheal tubes have revolutionized the anesthetic management of patients undergoing thoracic surgery. As experience with the techniques of DLT placement and monitoring progress, an increasing number of uses in the intensive care unit will evolve. ⋯ Isolation of the lungs to prevent contralateral spread of hemoptysis is occasionally of assistance. Frequent monitoring of DLT position while understanding the physiology of differential lung ventilation will minimize complications with these tubes.
-
Randomized Controlled Trial Clinical Trial
Effect of lung hyperinflation and endotracheal suctioning on heart rate and rhythm in patients after coronary artery bypass graft surgery.
We examined the effect of lung hyperinflation and suction on PaO2, heart rate, and rhythm in patients after coronary artery bypass graft surgery (N = 26). Three lung hyperinflation breaths, at one of five randomly ordered volumes (tidal volume, 12 cc/kg, 14 cc/kg, 16 cc/kg, or 18 cc/kg of lean body weight) were delivered, by a ventilator (fraction of inspired oxygen 1.0), followed by 10 seconds of continuous suction. Lung hyperinflation and suctioning were repeated three times. ⋯ The majority of rhythm changes for lung hyperinflation and suctioning were from normal sinus rhythm to sinus tachycardia. Suction was associated with a greater incidence of rhythm (53.9%) and arrhythmia (80.8%) changes. The most frequent arrhythmia was premature atrial contraction.