CDC new definition of ventilator associated pneumonia (events)

http://www.cdc.gov/nhsn/PDFs/Newsletters/VAE-Newsletter-September2012.pdf

Acid Base interpretation as easy as possible

I will try to simplfy the acid base interpretation as easy as I can.

then we'll post some cases and questions. (Adel Hammodi)

How to improve your odds for easier endotracheal intubation in intensive care unit

HOW TO IMPROVE YOUR ODDS FOR EASIER ENDOTRACHEAL INTUBATION

 

 

 

Intubation in critical care areas (outside the OR) is by default is considered as difficult. I think to reduce the possibility of facing difficult intubation or ventilation situations ,we must train our colleagues the best and proper way of intubation in the beginning.

this is some ideas for better odds for intubation:

1. Tips of fingers:
   use your tips of fingers to carry the laryngoscope and the tube. using the tips of fingers will help you to control and sense well every movement of the instruments also helping less trauma of the delicate mucosa.
2. Decrease your nerve and temper:
   yes it is stressful emergent situation to intubate critically ill patient but if you remember that your action well be better with calm behaviour and you will do better with quiet nerve . as you know , endogenous epinephrine induces muscle tension and it will increase your hand tremors.
3. Use best position of head ,neck and all body position:
   do your best to adjust your position and the patient position head extension , neck flexion ,ear to sternum position ,and other proper positions to improve visualisation of the glottis.
4. Start at the right angle of the mouth:
   open the mouth widely and start at the right angle of the mouth take the whole tongue to the left don't let a piece of the tongue obstruct your way to view the glottis.
5. Hold the tube at its end:
   don't hold the tube at its shaft it will obstruct your view on advancing it. start at the angle of the mouth so the view still wide and clear and use the tube curve to guide itself into the glottis don't try reposition inside the mouth as the field will be narrower and the teeth will not allow redirection.
   
   hope to get benefit from this note
   
   thanks

Value and Virtue

A lot of Ideas and views are wandering in my mind. May be it is the proper time to express and share. It is the value of being a Human Being is to share the good things and to accept the other ideas as long as they improve your prosper