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Percutaneous Tracheostomy in Critically ill patients
Percutaneous dilatational tracheostomy (PDT) is a commonly performed procedure in critically sick patients. It can be safely performed bedside by intensivists. This has resulted in decline in the use of surgical tracheostomy in intensive care unit (ICU) except in a few selected cases. Most common indication of tracheostomy in ICU is needed for prolonged ventilation. About 10% of patients requiring at least 3 days of mechanical ventilator support get tracheostomized during ICU stay. The ideal timing of PDT remains undecided at present. Contraindications and complications become fewer with increase in experience. Various methods of performing PDT have been discovered in the last two decades. Preoperative work up, patient selection and post tracheostomy care form key components of a successful PDT. Bronchoscopy and ultrasound have been found to be useful procedural adjuncts, especially in presence of unfavorable anatomy.
About the Speaker
Dr Hazem Lashin
FRCP FFICM FHEA PhD Consultant in Critical Care Medicine Faculty Tutor in Intensive Care Medicine Clinical Lead for High Dependency Unit Barts Heart Centre, St Bartholomew’s Hospital West Smithfield, London, EC1A 7BE
Upcoming Case Discussions
Technology Integration with Healthcare
Technology integration in healthcare is transforming the way medical services are delivered, enhancing efficiency and patient outcomes. Innovations such as telemedicine, electronic health records (EHR), and wearable devices allow for real-time monitoring and improved accessibility. Artificial intelligence (AI) and machine learning aid in early diagnosis and personalized treatment plans. Robotic surgeries and advanced imaging techniques offer precision and reduced recovery times. By combining technology with healthcare, providers can streamline operations, improve patient engagement, and deliver cost-effective care solutions.
Pediatric Obesity: Treatment Management
Treatment management for pediatric obesity combines lifestyle changes, family support, and, in severe cases, medical interventions. Family-based strategies are key, encouraging healthy eating habits, regular physical activity, and reduced screen time. Behavioral therapy helps set achievable goals and address barriers, empowering children and families to make sustainable lifestyle adjustments. Dietitians often assist in designing individualized meal plans that focus on nutrient-rich foods and limit calorie-dense options. In cases of severe obesity with related health conditions, medications or surgery may be considered, particularly for adolescents. Continuous monitoring and support from healthcare providers are essential for long-term success and health improvement.
Clinician’s Approach to Sleep Apnea
A clinician's approach to sleep apnea begins with a thorough assessment of the patient's medical history, symptoms (such as snoring, choking, and daytime fatigue), and risk factors like obesity or hypertension. Diagnosis is typically confirmed through polysomnography or home sleep apnea testing, followed by treatment strategies such as continuous positive airway pressure (CPAP), lifestyle modifications, or surgical interventions depending on the severity and type of sleep apnea.
Case Based Approach to Arthritis
A case-based approach to arthritis involves analyzing individual patient cases to tailor diagnostic and therapeutic strategies based on specific symptoms, disease progression, and underlying causes. This method enhances clinical decision-making by providing personalized treatment plans and improving patient outcomes in conditions like osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.
Falls and Fractures in Older Adults: Prevention and Immediate Care
Falls and fractures in older adults are common and can lead to significant morbidity, highlighting the importance of fall prevention strategies such as strength training, balance exercises, and home safety modifications. Immediate care involves quick assessment for fractures, pain management, and stabilization, along with appropriate transport to healthcare facilities for further evaluation and treatment.