I am surprised this was such a problem that it was reviewed in a medical journal. I’ve never had any patients come in for cinnamon aspiration, and they would probably be the laughing stock of the ICU.
Q:I am by no means doubting what you said, as you have a much deeper knowledge of airway than I do, but do you have the literature you referenced so that I may read it and share it as well? That would be awesome. Also again I am not trying to argue with you because you have much more training and knowledge than me, but I feel like if the patient is so bronchoconstricted that their lungsounds are absent, they need assisted vent with the neb till they can use the regular neb, no? thanks so much!!!
Why yes I do, it was mentioned in the July 2012 issue of the “Respiratory Care” science journal. Read the editorial on page 1195 after.
I should have clarified (and you are right in one respect). Airway deposition is actually increased threefold when you bag in a treatment…but only for intubated/trached patients (the study cited used an in vitro model). I would think that if you are just bagging an unintubated patient with a nebulizer attached, deposition would actually be reduced due to having to pass through the upper airway first.
If the patient has gone into ‘silent chest’, chances are they are going to be intubated and placed on continuous albuterol via a vibrating mesh or ultrasonic nebulizer inline with a ventilator. One could even set up said sorts of nebulizer with a bipap if the patient isn’t ventilating at all, but you would probably run into the same problems as seen above. However, a higher concentration of a continuous albuterol solution (say 20 mg/hour) would probably help make up for it.
I am by no means perfect. Heck, I’ll even publish this. Thanks for pointing out the inconsistency!
This is the stupidest thing I have ever seen. Is this real? Where is the source?
1) How can you give a neb when the neb pot is sideways?
2) In what situation would you need to give a neb during CPR?
This is for assisting ventilations only. You would…
A recent study has shown that bagging in a nebulized medication is less effective than just a plain high flow in line nebulizer. Most of the drug just hits the upper airway and doesn’t get to where it needs to get to. I have a co worker who is infamous for pulling shit like this. Yes, I think he’s an idiot.
EDIT: Thank you thebeachmedic for your email. Check your inbox for my response.
A demonstration of breath filling human lungs
The demonstration is performed with the deeply appreciated gift of a human body from a donor program, with no fixatives added. Integral anatomy is an approach to learning anatomy by studying whole textural layers, and noticing our relationships with them. Inspiration is a key to wholesome healthy living. Enjoy the pleasure of breathing: every inhalation is a gift!
In answer to the question, “How is this done?”: An instrument has been introduced into the airway of the form through which air is being delivered to inflate the lungs at the pace of human breath. The rib-basket has been reflected and removed to enable viewing of the process of the lungs filling with air. Breath while you watch, it is an expansive experience.
Canberra doctors removed a 10-centimetre fork from inside an elderly man’s penis after a bizarre sexual mishap.
The 70-year-old arrived at the Canberra Hospital emergency department with a bleeding organ.
He told doctors he had inserted the 10cm dining fork into his urethra almost 12 hours earlier in an attempt to achieve gratification.
But the utensil became stuck.
The fork was not visible but doctors were able to feel it from the outside and X-rays showed its position.
It was probably obscured by his forkskin.
I’ve had a patient who had a dildo stuck up his rectum, but a fork up the URETHRA?
I’m glad I don’t have to work traumas like this.
Preterm Babies at Risk for Later Cognitive Difficulties
$3 Million NIH grant will fund impact of preterm birth on early cognitive development and academic measures
Researchers at the University of California, San Diego have received a five-year, $3 million grant from the Eunice Kennedy Shriver Institute of Child Health and Human Development, part of the National Institutes of Health (NIH). The grant will fund a longitudinal study designed to track the developmental trajectory in cognitive, academic and brain measures as very preterm children transition from preschool to grade school. Results will provide the foundation for designing appropriate learning interventions.
“Even healthy preterm babies are at high risk for lower academic achievement, especially in math,” said Natacha Akshoomoff, PhD, of the Department of Psychiatry and UC San Diego’s Center for Human Development.
Preterm children who are deemed “normal” in terms of their development at infant/toddler stages may still remain at risk for significant math difficulties, as well as deficits in attention, executive functions, and spatial skills.
“Recent studies have identified a common pattern of subtle abnormality in the deep white matter of the brain among children born very premature. These early abnormalities may affect the subsequent development of widely distributed brain areas, and may account for the patterns of cognitive deficit that are observed later in childhood,” said Akshoomoff. “However, there is currently very little data actually linking these neural abnormalities with the emergence of such deficits and associated early academic difficulties. The goal of the current study is to provide these essential data as children enter a critical developmental stage when intervention may have the best potential to achieve better outcomes for these children.”