NURSINGBABU

  DEFINATION OF MECHANICAL VENTILATION  Meaning of Mechanical Ventilation In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing. INDICATIONS   Protection of airway   Respiratory arrest or rate < 8/min   Tachypnoea > 35/min   Inability to tolerate oxygen mask/CPAP/NIV, e.g. agitation,confusion  Removal of secretions   Hypoxaemia (Pa O2 < 8 kPa (< 60 mmHg); Sp O2 < 90%),despite CPAP with F iO2 > 0.6  Hypercapnia if conscious level impaired or risk of raised intracranial pressure   Worsening respiratory acidosis  Vital capacity falling below 1.2 L in patients with neuromuscular disease   Removing the work of breathing in exhausted patients   CLINICAL CONDITIONS   Post-operative • e.g. After major abdominal or cardiac surgery  Respiratory failure   ARDS   Acute severe asthma   Pneumonia   Aspiration   COPD   Smoke inhalati...

 1. WHAT IS ENDOTRACHEAL INTUBATION ?   Endotracheal intubation is the placement of a special tube in trachea 2. WHAT ARE THE INDICATION OF INTUBATION ?   * To secure airway * to supply oxygen * general Anesthesia  *Cardio pulmonary resucitation * ventilatory therapy in ICU  3. EQUIPMENTS REQUIRED FOR INTUBATION  *Different sizes of cuffed and plain ET TUBE   0-1 yrs-  2.5 to 3.5 mm ( plain )  1-3 yrs- 4to 5 mm   4-6 yrs - 5 to 6 mm   6-10 yrs - 6 to 7 mm( cuffed )  adult female - 7 to 8 mm   adult male - 8 to 9 mm   *laryngoscope * magill's forceps * Stethoscope  * syringe  *source for ventilation *suction   4. TECHNIQUE OF INTUBATION  *Raise the head by 5cm with a block or ring pillow  * Extension at atlanto-occipital joint * Flexion at neck  * hold the laryngoscpoe with LEFT hand irrespective of dominant hand * open the mouth with right hand inde...

 1. DEFINATION -  An arterial line is an invasive method to measure BP 2. MEDICAL USES OF ARTERIAL LINE   *Continuous, beat-to-beat blood pressure measurement.  *Hemodynamically unstable pts /ICU pts requiring inotropic support  *Patients undergoing major surgery  *Frequent arterial blood gas analysis  *pts with respiratory failure on ventilator  *severe acid/base disturbance.5. 3. Facilitation of reliable titration of vasoactive medications.  *Unable to obtain non invasive BP  * Known deficiencies in collateral circulation: Raynauds phenomenon, Thromboangitis obliterans, Brachial artery insufficiency 3. ADVANTAGES OF IBP MEASUREMENT   Continuous blood pressure recording   Accurate blood pressure recording even when patients are profoundly hypotensive vs NIBP which is difficult or inaccurate  4. PREFEABLE SITE FOR ARTERIAL LINE    The radial artery has low complication rates compared with other sites.  ...

  CENTRAL LINE VS THEIR INDICATION, PROCEDURE OF INSERTION AND ITS MAINTENANCE * DEFINATION - Central line is a type of catheter that is placed in a large vein that allows multiple IV fluids to be given and blood to be drawn. When compared to a typical IV line, a central line is larger, can stay in place longer, can deliver a greater volume of fluids, and allows blood to be drawn easily. A central venous catheter (CVC), also known as a central line, central venous line, or central venous access catheter, is a catheter placed into a large vein.  * REGULAR SITES : Catheters can be placed in veins,  • Neck (internal jugular vein),  • Chest (subcalvin vein or axillary vein),  • Groin (femoral vein), • Peripherally inserted central catheters.(PICC) 3. MEDICAL USES OF CENTRAL LINE  • Administer medication  • Fluids that are unable to be taken by mouth  • Would harm a smaller peripheral lines  • Obtain blood tests  • Measure central venous pr...