In the FOAM community a great deal of time is spent discussing the appropriate manner of transitioning critically ill patients onto mechanical ventilation. A far larger portion of the practice of critical care is spent determining how best to liberate our patients from the ventilatory shackles with which we have bound them. The specifics of […]
. Case example . A previously healthy 45-year-old man was transferred to the Genius General Hospital ICU for management of pneumonia. He was intubated prior to transfer due to hypoxemia (details unavailable). His chest radiograph showed dense right lower lobe consolidation, which was confirmed with ultrasonography. He was treated with a regimen of dexamethasone, […]
0 Background: Post-extubation failure and noninvasive ventilation (NIV) 0 Post-extubation respiratory failure requiring re-intubation is a major setback for any critically ill patient. Current evidence mainly involves the pre-emptive use of NIV to reduce post-extubation failure, particularly in hypercapnic COPD patients. However, in practice this is difficult to implement widely. Except for the sickest COPD […]
In this podcast, I discuss extubating patients in the ED. Specifically, I deal with patients who have only been intubated for a few hours in distinction to extubation of the patient who has been lingering in your ED for 2-3 days. The best patients for this short-term extubation are those intox folks with a low GCS and signs of trauma, overdoses, or endoscopy cases.