Respiratory diseases Archives - Hospital Procedures Consultants

Dispelling Myths about Thoracentesis and Pleural Fluid Analysis

October 25, 2022

More Articles – Cardiovascular diseases, Featured, medical procedures, Nephrology, Respiratory diseases

More Tags – CHF, diuretics, exudate, featured, HPC updates, Light's criteria, pleural effusions, pleural fluid analysis, re-expansion pulmonary edema, thoracentesis, transudate

There are two myths that have persisted about thoracentesis and pleural fluid analysis that must be dispelled. The first myth is that a large volume thoracentesis should not remove more than 1,500 mL fluid due to the risk of re-expansion…

What is the true complication rate for thoracentesis?

Joseph Esherick, M.D., FAAFP, FHM

October 25, 2022

More Articles – Cardiovascular diseases, medical procedures, Respiratory diseases

More Tags – featured procedure, hemothorax, HPC updates, pneumothorax, re-expansion pulmonary edema, thoracentesis, thoracentesis complications, ultrasound-guided procedures

Thoracentesis is one of the most common bedside procedures performed in U.S. hospitals. There are about 173,000 thoracenteses performed each year in the U.S. A systematic review and meta-analysis in 2010 concluded that thoracentesis-related pneumothorax occurs 6% of the time…

Clinical Pearls for Airway Management of Morbidly Obese Patients

Joseph Esherick, M.D., FAAFP, FHM

August 23, 2022

More Articles – Featured, Gastrointestinal diseases, Medical General, medical procedures, Respiratory diseases

More Tags – airway management, awake intubation, cricothyroidotomy, Difficult Intubation, featured, Glidescope intubation, ketamine, Ketofol, King tube airway, laryngeal mask airway, lorazepam, mechanical ventilation, midazolam, morbid obesity, paralytics, Propofol, video laryngoscopy

Morbidly obese patients can pose numerous challenges when it comes to airway management. Morbid obesity can make vascular access more difficult and you need good vascular access prior to any attempts at safe airway management. In addition, morbid obesity can…

Outpatient Management of A Spontaneous Pneumothorax

Joseph Esherick, M.D., FAAFP, FHM

July 2, 2022

More Articles – Cardiovascular diseases, Featured Procedure, medical procedures, Respiratory diseases

More Tags – chest tube, featured procedure, HPC updates, pneumothorax, tube thoracostomy

A patient with a hemodynamically stable spontaneous pneumothorax can be managed as an outpatient using the placement of a small-bore pigtail catheter attached to a Heimlich valve. As the Director of Medicine at a teaching hospital, I frequently encounter…

Pearls about Chest Tube Management

Joseph Esherick, M.D., FAAFP, FHM

July 2, 2022

More Articles – Cardiovascular diseases, Featured, Infections, medical procedures, Respiratory diseases

More Tags – air leak, chest tube placement, Chest tube removal, chest tubes, empyema, featured, hemothorax, HPC updates, parapneumonic effusion, pneumothorax, thoracentesis, tube thoracostomy

Chest tubes, or thoracostomy tubes, have been used since the fifth century BC when Hippocrates described the use of a hollow tin tube to drain fluid that was likely an empyema from his description.[i] Chest tubes started to be used…

The Jury is Still Out on Whether Awake Prone Positioning in Non-intubated Patients with COVID-19 Pneumonia Decreases Mortality or Endotracheal Intubation

https://hospitalprocedures.org/endotracheal-intubation-course/

Joseph Esherick, M.D., FAAFP, FHM

June 7, 2022

More Articles – Featured, medical procedures, Respiratory diseases

More Tags – baritinib, COVID, COVID pneumonia, COVID-19, dexamethasone, endotracheal intubation, featured, HPC updates, intubation, remdesevir, respiratory failure, tociluzimab

COVID-19 pneumonia can be a frustrating infection to treat because we have limited medications that have proven benefit in moderate-severe infections. Patients with COVID-19 pneumonia who require up to 2L/min supplemental oxygen have at least moderate infection. Patients with severe…

Tricks of the Trade for Stylet-guided Endotracheal Intubations

Joseph Esherick, M.D., FAAFP, FHM

June 7, 2022

More Articles – Featured Procedure, medical procedures, Respiratory diseases

More Tags – airway management, endotracheal intubation, featured procedure, HPC updates

Eschmann stylets, or Bougies, can assist the clinician with endotracheal intubation in difficult airway scenarios. The stylet when properly placed can act to guide the endotracheal tube (ETT) into the trachea. However, there are different troubleshooting techniques that once must…

Dexmedetomidine and Propofol performed equally well for the sedation of mechanically ventilated patients with sepsis

Joseph Esherick, M.D., FAAFP, FHM

April 15, 2022

More Articles – Featured, Medical General, medical procedures, Respiratory diseases

More Tags – ABCDEF bundle, CAM -ICU, Delirium, dexmedetomidine, featured, HPC updates, mechanical ventilation, Propofol, RASS, ventilator, ventilator sedation

The Society of Critical Care Medicine (SCCM) recommends that all mechanically ventilated patients receive analgesia, sedation, and delirium assessment and management while intubated. SCCM reinforced these principles in their 2018 clinical practice guideline on the prevention and management of pain,…

Protocolized Sedation is Recommended Over Usual Care for Mechanical Ventilation

Joseph Esherick, M.D., FAAFP, FHM

April 15, 2022

More Articles – Featured Procedure, Medical General, medical procedures, Respiratory diseases

More Tags – Delirium, featured procedure, HPC updates, mechanical ventilation, Protocolized Sedation, Sedation, Wake-up and Breath Protocol

A systematic review and meta-analysis of randomized controlled trials was conducted to determine the effects of protocolized sedation in mechanically ventilated adult intensive care unit patients. Six randomized controlled trials and 1243 patients were studied. The results showed that protocolized…

Review of chest tube drainage of the pleural space

Joseph Esherick, M.D., FAAFP, FHM

January 12, 2022

More Articles – Cardiovascular diseases, Featured, medical procedures, Respiratory diseases

More Tags – chest tube placement, Chest tube removal, chest tubes, featured, hemothorax, HPC updates, pigtail catheter placement, pleural effusions, pleurodesis, pneumothorax, re-expansion pulmonary edema, tube thoracostomy

This blog summarizes recommended management of chest tube drainage of the pleural space. The blog will cover the recommended size of chest tube for different indications, suggestions for chest tube insertion technique, methods to avoid chest tube complications and when…

Airway Management Pearls to Optimize Your Chances of Securing an Airway

Joseph Esherick, M.D., FAAFP, FHM

December 6, 2021

More Articles – Cardiovascular diseases, Featured, Medical General, medical procedures, Respiratory diseases

More Tags – airway management, Bougie, delayed sequence intubation, difficult airway, endotracheal intubation, featured, HPC updates, intubation, King tube, LMA, mechanical ventilation, rapid sequence intubation

TOP TEN AIRWAY MANAGEMENT PEARLS TO OPTIMIZE YOUR CHANCES OF SECURING AN AIRWAY Develop a difficult airway management plan Huddle with your nurse and respiratory therapist in advance to alert everybody what plan A/B/C/D are for the patient If plan…

The Likelihood of a Difficult Intubation

Joseph Esherick, M.D., FAAFP, FHM

December 6, 2021

More Articles – Featured Procedure, medical procedures, Respiratory diseases

More Tags – airway management, endotracheal intubation, featured procedure, HPC updates

A recent article in JAMA reviewed 62 high-quality articles to determine the clinical factors that can help to predict the patient with a difficult airway. Airway management experts have devised different scoring systems and exam findings that can predict the…

Procedural Competency in Academic Emergency Medicine Attending Physicians

Joseph Esherick, M.D., FAAFP, FHM

November 4, 2021

More Articles – Cardiovascular diseases, Featured, medical procedures, Respiratory diseases

More Tags – ACLS, chest tube placement, difficult airway management, endotracheal intubation, featured, HPC updates, intraosseous line placement, intubation, lumbar puncture, paracentesis, pericardiocentesis, procedural sedation, thoracentesis, tube thoracostomy

A recent article summarizes a cross-sectional survey aimed at determining the processes in place to assess the procedural competency of academic emergency medicine attendings.[i] The survey was sent to the 39 ACGME-accredited Emergency Medicine programs in the U.S. and had…

Simulation Based Training Improves Airway Management Skills

Joseph Esherick, M.D., FAAFP, FHM

November 4, 2021

More Articles – Cardiovascular diseases, Featured Procedure, Gastrointestinal diseases, Medical General, medical procedures, Respiratory diseases

More Tags – airway management, central lines, endotracheal intubation, Glidescope intubation, King tube, laryngeal mask airway, lumbar puncture, paracentesis, thoracentesis

Simulation-based procedural training has been shown to improve procedural competence, safety, operator confidence and most importantly patient safety for every bedside procedure studied. Now, a new systematic review and meta-analysis confirms that simulation-based training in airway management improves procedural competence…

Tips for Management and Bedside Procedures in Critically Ill Patients with COVID Pneumonia

Joseph Esherick, M.D., FAAFP, FHM

October 15, 2021

More Articles – Cardiovascular diseases, Featured, Gastrointestinal diseases, Medical General, medical procedures, Respiratory diseases

More Tags – Arterial line insertion, asystole, cardiac arrest, Central line insertion, COVID pneumonia, CPR, featured, Glidescope intubation, HPC updates, intubation, mechanical ventilation, PEA, push dose pressors, video laryngoscopy

The SARS-COV-2 pandemic started in January 2020 and has decimated the majority of U.S. hospitals for the past 18 months. The impact of COVID-19 has not only affected available hospital beds, but has limited the ability of hospitals to perform…

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