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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
Treatment of Renal Disease in ANCA Vasculitis
The treatment of renal disease in ANCA-associated vasculitis (AAV) typically involves a combination of immunosuppressive therapies to control inflammation and prevent further kidney damage. First-line treatment often includes high-dose corticosteroids and cyclophosphamide or rituximab, both of which help to induce remission by targeting the underlying immune system dysfunction. In cases of kidney failure or rapidly progressive glomerulonephritis, plasmapheresis may be used to remove circulating autoantibodies. Once remission is achieved, maintenance therapy with lower doses of immunosuppressants, such as azathioprine or mycophenolate mofetil, is used to prevent relapses and preserve kidney function.
Management of Pediatric Type 1 Diabetes
Pediatric type 1 diabetes management focuses on maintaining glycemic control while supporting normal growth. Insulin therapy, via multiple daily injections or pumps, is essential, with doses adjusted based on blood glucose monitoring or continuous glucose monitoring (CGM). Nutrition plans emphasizing carbohydrate counting and balanced meals are crucial, alongside adjustments for physical activity to prevent glucose fluctuations. Education for families on recognizing hypo- and hyperglycemia symptoms and managing sick days is vital. Regular follow-ups with a pediatric endocrinologist help monitor HbA1c levels, growth, and complications. Psychosocial support is key for ensuring adherence and addressing emotional challenges.
Rising Cardiac Arrests in Young Entrepreneurs
The increasing cases of cardiac arrests among young entrepreneurs are becoming a serious health concern. Intense stress, long working hours, unhealthy eating habits, and lack of physical activity are major contributors to heart-related issues in this group. This often leads to neglecting personal health, resulting in irregular sleep patterns and chronic fatigue. Additionally, skipping regular medical check-ups can leave underlying heart conditions undetected. Emphasizing stress management, healthy lifestyle choices, and routine health screenings is crucial to reducing this growing risk
Analytical Skills in Problem Solving
Today’s session on analytical tools and techniques in healthcare can provide valuable insights into how data-driven approaches enhance decision-making and problem-solving. Sharing personal or professional experiences where analytical skills were effectively used to address challenges can offer practical understanding and inspire learners. These skills are crucial in healthcare for accurate patient diagnosis, effective treatment planning, and efficient resource allocation. By applying analytical methods, healthcare professionals can improve patient outcomes, streamline operations, and make informed, evidence-based decisions that contribute to overall healthcare efficiency and quality.
Building Strong Interpersonal Relationships
A case discussion can highlight real-life situations where strong interpersonal relationships are essential, such as handling challenging patients or working effectively with colleagues. Sharing personal or professional experiences, or observations of successful interactions, can provide valuable insights. Emphasizing the key factors that contributed to building trust, mutual respect, and effective communication can help illustrate how strong relationships improve collaboration and patient care. This approach encourages participants to reflect on their own interactions and apply these strategies in their professional environments.