Icuextubationsafetychecklist 131202010224-phpapp02
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This document outlines a 3 step process for assessing risk of extubation failure and preparing patients for extubation. Step 1 involves screening criteria to identify high or low risk patients. Step 2 assesses additional risk factors that could classify a patient as high risk. Step 3 prepares patients for extubation based on their risk, with specific protocols and monitoring for immediate high risk, delayed high risk, and low risk patients. The goal is to identify risk factors, communicate extensively among teams, and closely monitor patients post-extubation to prevent reintubation issues.
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This document discusses damage control surgery (DCS), which is an abbreviated laparotomy designed to prioritize physiological recovery over anatomical reconstruction for seriously injured patients. It has four phases: pre-hospital resuscitation (Phase 0), abbreviated laparotomy to control bleeding and contamination (Phase I), intensive care to restore physiology (Phase II), and definitive repair once stabilized (Phase III). The goals of DCS are to restore physiology first before completing anatomical reconstruction, in order to improve survival outcomes for major trauma patients.
Preterm neonates & complications
This document provides an overview of prematurity, including definitions, epidemiology, complications, management, and feeding recommendations. Prematurity is defined as birth before 37 weeks gestation and can be classified by gestational age or birth weight. Complications of prematurity include respiratory distress, intraventricular hemorrhage, retinopathy of prematurity, necrotizing enterocolitis, and apnea. Management involves prevention strategies like antenatal steroids and supportive care like supplemental oxygen and antibiotics. Feeding recommendations start with minimal enteral feeds advancing slowly based on tolerance to minimize risks like necrotizing enterocolitis.
10152_GALLANT9
This document provides guidance on inclusion/exclusion criteria, lab discontinuation criteria, conversions, abbreviations, and handling plans for a clinical trial. It outlines criteria for enrolling and continuing patients in the trial based on lab values such as hemoglobin, neutrophil count, creatinine, liver enzymes, and CK. It also provides handling plans for managing out-of-range lab values to determine if and when a patient needs to discontinue the investigational product.
Basis of surgical ICU
This document provides guidance on patient management in a surgical intensive care unit (SICU). It discusses indications for SICU admission including major surgeries, trauma, and medical complications. It outlines general care practices in the SICU such as airway management, feeding, infection control, and prevention of complications. The document also reviews criteria for mechanical ventilation, parameters for ventilator settings, weaning from ventilation, and discharge from the post-anesthesia care unit. It presents a case of a child with tracheal injury who required intubation and mechanical ventilation in the SICU.
Sridhar presentation
The document discusses the pre-anesthesia consultation (PAC) process. It defines PAC as the clinical assessment of patients before anesthesia for surgery or non-surgical cases. The goals of PAC are to identify the patient, take their history, conduct a physical exam, identify medical conditions, order tests, manage medications, and provide pre-operative instructions. Benefits include reducing patient anxiety, optimizing health before surgery, and decreasing costs. The document outlines the components of a thorough PAC including airway assessment, cardiac and other system evaluations, recommended tests, medication management, and pre-operative guidelines.
Est
Exercise stress testing can be used to identify cardiovascular endurance and the likelihood of coronary artery disease. There are several types of stress tests that use equipment like treadmills, bicycles, or arm ergometers along with electrocardiogram monitoring. The tests aim to determine if physical exertion causes ischemia or inadequate oxygen supply to the heart. Results are reported as negative, positive, or inconclusive based on changes in the ECG tracing during physical exertion. Precautions must be taken as the tests carry a risk of inducing dangerous cardiac events.
Dengue
This patient is a 30-year-old female who presented with a 5-day history of intermittent fever, body malaise, and chills. On examination, she had a fever of 38°C. Based on her symptoms and residence in a dengue-endemic area, the impression is dengue fever without warning signs. The document then provides definitions and treatment guidelines for dengue fever without warning signs, dengue with warning signs, and severe dengue.
Haemorrhage Control in Trauma
Dr. Duncan Redmill discusses advances in trauma care focusing on haemorrhage control. He notes that haemorrhage accounts for 30-40% of trauma deaths within 6 hours and can be prevented through early recognition and rapid control of blood loss. The case report describes a 62-year-old pedestrian hit by a car doing 40mph who was found to have a complex liver laceration and haemoperitoneum causing massive haemorrhage. Modern trauma care focuses on damage control resuscitation to manage bleeding and coagulopathy as early as possible through techniques like tourniquet use, permissive hypotension, massive transfusion protocols, and adjuncts to replace clotting factors.
Paediatric septic-shock
An 8 year old female presented with signs of septic shock including a heart rate of 180, respiratory rate of 35, and hypotension. Initial assessments found a temperature of 39.9°F, respiratory rate of 32 breaths/min, blood pressure of 70/50 mmHg, and oxygen saturation of 90% on room air. The patient appeared tired and had delayed capillary refill of 4 seconds.
Paediatric septic shock remains a significant cause of morbidity and mortality worldwide. Early goal directed therapy is crucial and aims to achieve specific clinical targets within 6 hours such as a central venous pressure of 8-12 mmHg, mean arterial pressure over 65 mmHg, urine output over 0.5 ml/kg/
Peritonectomy2 Asgo 2007
Peritonectomy is a surgical technique used to treat advanced ovarian cancer that aims to remove all visible tumor from the peritoneal cavity. A study was conducted on peritonectomies performed at the Queensland Centre for Gynaecological Cancer to evaluate the safety and outcomes. The results showed that peritonectomy can debulk tumor down to less than 2cm in size, with smaller residuals associated with better survival rates. However, going from 2cm or less to no visible tumor takes significantly more time and expertise. Patient selection remains a challenge, but modified peritonectomy appears to be a viable option for some advanced ovarian and primary peritoneal cancer cases. Training future surgeons in these complex procedures is important to improving patient outcomes.
CIN.ppt
This document discusses the management of cervical intraepithelial neoplasia (CIN). It defines CIN and describes its grading from CIN1 to CIN3 based on the level of involvement of the cervical epithelium. For CIN1, observation or treatment are accepted depending on factors like age and lesion characteristics. CIN2/3 should be treated as regression is only 30-40% and progression risk is higher. Accepted treatment modalities include ablation methods like cryotherapy or laser vaporization and excisional methods like LEEP. Follow up is important after treatment to monitor for regression or recurrence.
Critical Pathways For Cardiac Surgery
The document outlines the critical pathways for cardiac surgery patients from pre-operative preparation through post-operative recovery up to discharge. It includes examinations, investigations, consultations, medications, activity levels, and education required on each day leading up to and following surgery.
Weaning From Mechanical Ventilation
Weaning
Mechanical Ventilation
Weaning Failure
RSBI
SBT
PSV
Criteria of weaning
Extubation
Cuff Leak test
Weaning and discontinuation
The document discusses weaning patients off mechanical ventilation. It defines weaning as the transition from full ventilator support to spontaneous breathing. Patients can have simple, difficult, or prolonged weaning depending on how many spontaneous breathing trials they require. Daily screening checks if patients meet criteria for an initial spontaneous breathing trial. Successful trials are then followed by extubation. Patients who fail trials should have their causes investigated and corrected before retrying weaning.
Mechanical vent rules to know while taking the TMC
This presentation includes Mechanical Ventilator Testing tips for NBRC's Therapist Multiple Choice Exam, suitable for the test during or after 2015. License Attribution Creative Commons for ZTC (Zero Textbook Courses)
Similar to Icuextubationsafetychecklist 131202010224-phpapp02 (20)
BCC4: Michael Parr on ICU - Surviving Trauma Guidelines
BCC4: Michael Parr on ICU - Surviving Trauma Guidelines
Mechanical vent rules to know while taking the TMC
Mechanical vent rules to know while taking the TMC
Recently uploaded
Microsoft - Power Platform_G.Aspiotis.pdf
Revolutionizing Application Development
with AI-powered low-code, presentation by George Aspiotis, Sr. Partner Development Manager, Microsoft
HCL Notes und Domino Lizenzkostenreduzierung in der Welt von DLAU
Webinar Recording: https://www.panagenda.com/webinars/hcl-notes-und-domino-lizenzkostenreduzierung-in-der-welt-von-dlau/
DLAU und die Lizenzen nach dem CCB- und CCX-Modell sind für viele in der HCL-Community seit letztem Jahr ein heißes Thema. Als Notes- oder Domino-Kunde haben Sie vielleicht mit unerwartet hohen Benutzerzahlen und Lizenzgebühren zu kämpfen. Sie fragen sich vielleicht, wie diese neue Art der Lizenzierung funktioniert und welchen Nutzen sie Ihnen bringt. Vor allem wollen Sie sicherlich Ihr Budget einhalten und Kosten sparen, wo immer möglich. Das verstehen wir und wir möchten Ihnen dabei helfen!
Wir erklären Ihnen, wie Sie häufige Konfigurationsprobleme lösen können, die dazu führen können, dass mehr Benutzer gezählt werden als nötig, und wie Sie überflüssige oder ungenutzte Konten identifizieren und entfernen können, um Geld zu sparen. Es gibt auch einige Ansätze, die zu unnötigen Ausgaben führen können, z. B. wenn ein Personendokument anstelle eines Mail-Ins für geteilte Mailboxen verwendet wird. Wir zeigen Ihnen solche Fälle und deren Lösungen. Und natürlich erklären wir Ihnen das neue Lizenzmodell.
Nehmen Sie an diesem Webinar teil, bei dem HCL-Ambassador Marc Thomas und Gastredner Franz Walder Ihnen diese neue Welt näherbringen. Es vermittelt Ihnen die Tools und das Know-how, um den Überblick zu bewahren. Sie werden in der Lage sein, Ihre Kosten durch eine optimierte Domino-Konfiguration zu reduzieren und auch in Zukunft gering zu halten.
Diese Themen werden behandelt
- Reduzierung der Lizenzkosten durch Auffinden und Beheben von Fehlkonfigurationen und überflüssigen Konten
- Wie funktionieren CCB- und CCX-Lizenzen wirklich?
- Verstehen des DLAU-Tools und wie man es am besten nutzt
- Tipps für häufige Problembereiche, wie z. B. Team-Postfächer, Funktions-/Testbenutzer usw.
- Praxisbeispiele und Best Practices zum sofortigen Umsetzen
Observability Concepts EVERY Developer Should Know -- DeveloperWeek Europe.pdf
Monitoring and observability aren’t traditionally found in software curriculums and many of us cobble this knowledge together from whatever vendor or ecosystem we were first introduced to and whatever is a part of your current company’s observability stack.
While the dev and ops silo continues to crumble….many organizations still relegate monitoring & observability as the purview of ops, infra and SRE teams. This is a mistake - achieving a highly observable system requires collaboration up and down the stack.
I, a former op, would like to extend an invitation to all application developers to join the observability party will share these foundational concepts to build on:
みなさんこんにちはこれ何文字まで入るの？40文字以下不可とか本当に意味わからないけどこれ限界文字数書いてないからマジでやばい文字数いけるんじゃないの？えこ...
ここ3000字までしか入らないけどタイトルの方がたくさん文字入ると思います。
Essentials of Automations: The Art of Triggers and Actions in FME
In this second installment of our Essentials of Automations webinar series, we’ll explore the landscape of triggers and actions, guiding you through the nuances of authoring and adapting workspaces for seamless automations. Gain an understanding of the full spectrum of triggers and actions available in FME, empowering you to enhance your workspaces for efficient automation.
We’ll kick things off by showcasing the most commonly used event-based triggers, introducing you to various automation workflows like manual triggers, schedules, directory watchers, and more. Plus, see how these elements play out in real scenarios.
Whether you’re tweaking your current setup or building from the ground up, this session will arm you with the tools and insights needed to transform your FME usage into a powerhouse of productivity. Join us to discover effective strategies that simplify complex processes, enhancing your productivity and transforming your data management practices with FME. Let’s turn complexity into clarity and make your workspaces work wonders!
Let's Integrate MuleSoft RPA, COMPOSER, APM with AWS IDP along with Slack
Discover the seamless integration of RPA (Robotic Process Automation), COMPOSER, and APM with AWS IDP enhanced with Slack notifications. Explore how these technologies converge to streamline workflows, optimize performance, and ensure secure access, all while leveraging the power of AWS IDP and real-time communication via Slack notifications.
HCL Notes and Domino License Cost Reduction in the World of DLAU
Webinar Recording: https://www.panagenda.com/webinars/hcl-notes-and-domino-license-cost-reduction-in-the-world-of-dlau/
The introduction of DLAU and the CCB & CCX licensing model caused quite a stir in the HCL community. As a Notes and Domino customer, you may have faced challenges with unexpected user counts and license costs. You probably have questions on how this new licensing approach works and how to benefit from it. Most importantly, you likely have budget constraints and want to save money where possible. Don’t worry, we can help with all of this!
We’ll show you how to fix common misconfigurations that cause higher-than-expected user counts, and how to identify accounts which you can deactivate to save money. There are also frequent patterns that can cause unnecessary cost, like using a person document instead of a mail-in for shared mailboxes. We’ll provide examples and solutions for those as well. And naturally we’ll explain the new licensing model.
Join HCL Ambassador Marc Thomas in this webinar with a special guest appearance from Franz Walder. It will give you the tools and know-how to stay on top of what is going on with Domino licensing. You will be able lower your cost through an optimized configuration and keep it low going forward.
These topics will be covered
- Reducing license cost by finding and fixing misconfigurations and superfluous accounts
- How do CCB and CCX licenses really work?
- Understanding the DLAU tool and how to best utilize it
- Tips for common problem areas, like team mailboxes, functional/test users, etc
- Practical examples and best practices to implement right away
Why You Should Replace Windows 11 with Nitrux Linux 3.5.0 for enhanced perfor...
The choice of an operating system plays a pivotal role in shaping our computing experience. For decades, Microsoft's Windows has dominated the market, offering a familiar and widely adopted platform for personal and professional use. However, as technological advancements continue to push the boundaries of innovation, alternative operating systems have emerged, challenging the status quo and offering users a fresh perspective on computing.
One such alternative that has garnered significant attention and acclaim is Nitrux Linux 3.5.0, a sleek, powerful, and user-friendly Linux distribution that promises to redefine the way we interact with our devices. With its focus on performance, security, and customization, Nitrux Linux presents a compelling case for those seeking to break free from the constraints of proprietary software and embrace the freedom and flexibility of open-source computing.
Removing Uninteresting Bytes in Software Fuzzing
Imagine a world where software fuzzing, the process of mutating bytes in test seeds to uncover hidden and erroneous program behaviors, becomes faster and more effective. A lot depends on the initial seeds, which can significantly dictate the trajectory of a fuzzing campaign, particularly in terms of how long it takes to uncover interesting behaviour in your code. We introduce DIAR, a technique designed to speedup fuzzing campaigns by pinpointing and eliminating those uninteresting bytes in the seeds. Picture this: instead of wasting valuable resources on meaningless mutations in large, bloated seeds, DIAR removes the unnecessary bytes, streamlining the entire process.
In this work, we equipped AFL, a popular fuzzer, with DIAR and examined two critical Linux libraries -- Libxml's xmllint, a tool for parsing xml documents, and Binutil's readelf, an essential debugging and security analysis command-line tool used to display detailed information about ELF (Executable and Linkable Format). Our preliminary results show that AFL+DIAR does not only discover new paths more quickly but also achieves higher coverage overall. This work thus showcases how starting with lean and optimized seeds can lead to faster, more comprehensive fuzzing campaigns -- and DIAR helps you find such seeds.
- These are slides of the talk given at IEEE International Conference on Software Testing Verification and Validation Workshop, ICSTW 2022.
National Security Agency - NSA mobile device best practices
Threats to mobile devices are more prevalent and increasing in scope and complexity. Users of mobile devices desire to take full advantage of the features
available on those devices, but many of the features provide convenience and capability but sacrifice security. This best practices guide outlines steps the users can take to better protect personal devices and information.
TrustArc Webinar - 2024 Global Privacy Survey
How does your privacy program stack up against your peers? What challenges are privacy teams tackling and prioritizing in 2024?
In the fifth annual Global Privacy Benchmarks Survey, we asked over 1,800 global privacy professionals and business executives to share their perspectives on the current state of privacy inside and outside of their organizations. This year’s report focused on emerging areas of importance for privacy and compliance professionals, including considerations and implications of Artificial Intelligence (AI) technologies, building brand trust, and different approaches for achieving higher privacy competence scores.
See how organizational priorities and strategic approaches to data security and privacy are evolving around the globe.
This webinar will review:
- The top 10 privacy insights from the fifth annual Global Privacy Benchmarks Survey
- The top challenges for privacy leaders, practitioners, and organizations in 2024
- Key themes to consider in developing and maintaining your privacy program
AI 101: An Introduction to the Basics and Impact of Artificial Intelligence
Imagine a world where machines not only perform tasks but also learn, adapt, and make decisions. This is the promise of Artificial Intelligence (AI), a technology that's not just enhancing our lives but revolutionizing entire industries.
Full-RAG: A modern architecture for hyper-personalization
Mike Del Balso, CEO & Co-Founder at Tecton, presents "Full RAG," a novel approach to AI recommendation systems, aiming to push beyond the limitations of traditional models through a deep integration of contextual insights and real-time data, leveraging the Retrieval-Augmented Generation architecture. This talk will outline Full RAG's potential to significantly enhance personalization, address engineering challenges such as data management and model training, and introduce data enrichment with reranking as a key solution. Attendees will gain crucial insights into the importance of hyperpersonalization in AI, the capabilities of Full RAG for advanced personalization, and strategies for managing complex data integrations for deploying cutting-edge AI solutions.
GraphSummit Singapore | Graphing Success: Revolutionising Organisational Stru...
Sudheer Mechineni, Head of Application Frameworks, Standard Chartered Bank
Discover how Standard Chartered Bank harnessed the power of Neo4j to transform complex data access challenges into a dynamic, scalable graph database solution. This keynote will cover their journey from initial adoption to deploying a fully automated, enterprise-grade causal cluster, highlighting key strategies for modelling organisational changes and ensuring robust disaster recovery. Learn how these innovations have not only enhanced Standard Chartered Bank’s data infrastructure but also positioned them as pioneers in the banking sector’s adoption of graph technology.
Infrastructure Challenges in Scaling RAG with Custom AI models
Building Retrieval-Augmented Generation (RAG) systems with open-source and custom AI models is a complex task. This talk explores the challenges in productionizing RAG systems, including retrieval performance, response synthesis, and evaluation. We’ll discuss how to leverage open-source models like text embeddings, language models, and custom fine-tuned models to enhance RAG performance. Additionally, we’ll cover how BentoML can help orchestrate and scale these AI components efficiently, ensuring seamless deployment and management of RAG systems in the cloud.
Video Streaming: Then, Now, and in the Future
In his public lecture, Christian Timmerer provides insights into the fascinating history of video streaming, starting from its humble beginnings before YouTube to the groundbreaking technologies that now dominate platforms like Netflix and ORF ON. Timmerer also presents provocative contributions of his own that have significantly influenced the industry. He concludes by looking at future challenges and invites the audience to join in a discussion.
“I’m still / I’m still / Chaining from the Block”
“An Outlook of the Ongoing and Future Relationship between Blockchain Technologies and Process-aware Information Systems.” Invited talk at the joint workshop on Blockchain for Information Systems (BC4IS) and Blockchain for Trusted Data Sharing (B4TDS), co-located with with the 36th International Conference on Advanced Information Systems Engineering (CAiSE), 3 June 2024, Limassol, Cyprus.
Recently uploaded (20)
HCL Notes und Domino Lizenzkostenreduzierung in der Welt von DLAU
HCL Notes und Domino Lizenzkostenreduzierung in der Welt von DLAU
Observability Concepts EVERY Developer Should Know -- DeveloperWeek Europe.pdf
Observability Concepts EVERY Developer Should Know -- DeveloperWeek Europe.pdf
みなさんこんにちはこれ何文字まで入るの？40文字以下不可とか本当に意味わからないけどこれ限界文字数書いてないからマジでやばい文字数いけるんじゃないの？えこ...
みなさんこんにちはこれ何文字まで入るの？40文字以下不可とか本当に意味わからないけどこれ限界文字数書いてないからマジでやばい文字数いけるんじゃないの？えこ...
Essentials of Automations: The Art of Triggers and Actions in FME
Essentials of Automations: The Art of Triggers and Actions in FME
Let's Integrate MuleSoft RPA, COMPOSER, APM with AWS IDP along with Slack
Let's Integrate MuleSoft RPA, COMPOSER, APM with AWS IDP along with Slack
HCL Notes and Domino License Cost Reduction in the World of DLAU
HCL Notes and Domino License Cost Reduction in the World of DLAU
Why You Should Replace Windows 11 with Nitrux Linux 3.5.0 for enhanced perfor...
Why You Should Replace Windows 11 with Nitrux Linux 3.5.0 for enhanced perfor...
National Security Agency - NSA mobile device best practices
National Security Agency - NSA mobile device best practices
AI 101: An Introduction to the Basics and Impact of Artificial Intelligence
AI 101: An Introduction to the Basics and Impact of Artificial Intelligence
Full-RAG: A modern architecture for hyper-personalization
Full-RAG: A modern architecture for hyper-personalization
GraphSummit Singapore | Graphing Success: Revolutionising Organisational Stru...
GraphSummit Singapore | Graphing Success: Revolutionising Organisational Stru...
Infrastructure Challenges in Scaling RAG with Custom AI models
Infrastructure Challenges in Scaling RAG with Custom AI models
Icuextubationsafetychecklist 131202010224-phpapp02
- 1. 1 STEP I Screen Passed SBT SAT Done Tracheal suction <q2h Minimal oral secretions Spontaneous cough Cuff leak SBT=Spontaneous Breathing Trial; SAT=Spontaneous Awakening Trial ! If yes to any of the screening items, patient automatically classified as High Risk - Delayed Failure. If all criteria met, STOP - proceed to routine extubation. Screen failure in any of the criteria place patient in categories above Low Risk.
- 2. 2 STEP II Assess Any Of The Following: C-Spine Surgery (>3 levels + operative time > 5 hrs or blood loss >300 mL) Restricted Airway Access Cervical Immobility/Instability History of Difficult Airway BMI >40kg/m2
- 3. 3 STEP II Assess >2 Of The Following: Age >60 years End Stage Kidney Disease Male Gender Tracheal Suctioning >q2h Coma (GCS <10) Frequent oral suctioning Chronic Lung Disease Failed >3 previous SBTs Positive Cardiac History ! ! !
- 4. 4 STEP III Prepare HIGH RISK: Immediate Failure Immediate post-extubation respiratory distress requiring reintubation w/in 2hrs of extubation. Difficult Airway Cart: at bedside Notify Anesthesia Airway Pager Allow Continuous Airway Access Hold Feeds: 2h pre- & 6h post-extubation Insulin Treated Patients: initiate dextrose Recommend: methylprednisolone 20mg IV q4h; 3 doses prior to extubation
- 5. 5 STEP III Prepare HIGH RISK: Delayed Failure Post-extubation respiratory distress requiring reintubation up to 24-48 hrs after extubation Backup Plan Notify ICU Team Consider ABG/VBG q12 h Respiratory Therapist Assess 4h post-extubation Bronchial Hygiene Protocol (if indicated)
- 6. 6 STEP III Prepare LOW RISK Routine extubation
- 7. 7 STEP III:Extubate IV Prepare Clear communication among teams, observation & monitoring Resume feeds after succesful intubation If reintubation, prepare smaller size endotracheal tube