Bedside Procedures in the ICU by Florian Falter

By Florian Falter

This guide is a consultant to top perform in interventions generally encountered within the ICU. it really is clinically oriented offering :step-by-step causes and illustrations of such a lot invasive strategies, money lists to ensure the indication is correct, cost lists to make sure acceptable overview as soon as the technique has been performed. the knowledge is well available offering sensible recommendation and crucial heritage for each member of the multi-disciplinary group taking good care of seriously in poor health sufferers. it is going to serve the senior advisor who has now not played a approach for it slow in addition to the junior health professional wanting an aide memoire.

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Chapter 4. 3 Ideal needle position in the tracheal lumen: central in the trachea, angled slightly caudally (Reproduced with kind permission from Smith Medical) • Next the guidewire is advanced into the cannula (see Fig. 4), again confirming intra-luminal placement with the bronchoscope. A “hold-up” will be felt as the tip of the wire enters a more distal bronchus. • A small short dilator is passed into the trachea and immediately removed again, followed by the sleeve for the guidewire, which is left in situ.

S. Parmar • Relief of airway obstruction − Inspissated secretions − Tumor debridement − Stenting − Removal of foreign bodies • Identification of bleeding points • Percutaneous tracheostomy (see Chap. 4) • Instillation of therapeutic agents Consent If not intubated and ventilated the indications for the procedure and potential complications associated with performing a FOB should be explained to the patient. Overall FOB is a safe procedure, which is generally well tolerated with very few major complications.

4). Generally, only patients with obtunded airway reflexes tolerate oropharyngeal airways. Attempting to insert one in a more awake patient may lead to vomiting and aspiration. • Nasopharyngeal airway: This airway is better tolerated in the more conscious patient, although insertion can be very uncomfortable. It is gently inserted into a nostril (see Fig. 5) – if resistance is felt, the contralateral side should be tried. This procedure is contraindicated in patients with suspected base of skull fracture.

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