Tidal Volume for a Bag-Valve Device.
Low tidal volumes should be used when positive-pressure ventilation is provided through a bag-valve device.
Several problems can arise during endotracheal intubation in critically ill patients, ranging from relatively minor to life-threatening, with the latter including inability to ventilate the lungs and hemodynamic collapse. If progressive desaturation occurs after the administration of anesthetic drugs, low-tidal-volume, positive-pressure ventilation with a bag-valve device should be initiated and endotracheal intubation expedited (Figure 4).
If endotracheal intubation is not successful on the first attempt, administer low-volume, positive-pressure ventilation through a face mask.3 The second operator may assist the first operator in endotracheal intubation by adjusting the patient’s position or the position of the bed, performing external laryngeal manipulation to provide a better view during laryngoscopy, or providing the first operator with airway adjuncts. If endotracheal intubation fails on the second attempt, the second operator may attempt to perform the intubation. Adequate oxygenation should be maintained by providing low-volume, positive-pressure ventilation with a face mask.
If face-mask ventilation is not adequate, a laryngeal mask airway should be placed. If ventilation does not occur after placement of the laryngeal mask airway, or if critical desaturation occurs, emergency front-of-neck access to the airway should be obtained.
In cases of cardiac arrest, the first and second operators should commence resuscitation immediately, in accordance with the guidelines for advanced cardiac life support. The third and fourth operators should put on PPE, enter the intubation room, and assist with cardiopulmonary resuscitation. Other health care personnel may provide assistance as necessary after donning appropriate PPE.4
"emergency" - Google News
February 18, 2021 at 05:00AM
https://ift.tt/3bcl6WI
Emergency Intubation in Covid-19 | NEJM - nejm.org
"emergency" - Google News
https://ift.tt/2VVGGYQ
https://ift.tt/3d7MC6X
emergency
Bagikan Berita Ini
0 Response to "Emergency Intubation in Covid-19 | NEJM - nejm.org"
Post a Comment