Term 5 Week 7 (w/c 04/03/13)
Apologies for the missing #gasclass last week.
This week we go back to the Intensive Care Unit. Case details will follow later in the week but we will start with the following question:
What are the indications for Tracheostomy?
Sorry for the delayed update today.
You are working on ICU and are asked to assess 54 year old man on the neurology ward. He was admitted 24 hours ago with ascending weakness intially affecting his feet and legs but now affecting his arms. He had an episode of diarrhoea a few days ago.
When would you admit this man to critical care?
You make the decision to admit the patient to the Intensive Care Unit. Over the course of the evening his weakness progresses and he develops bulbar symptoms. You decide to intubate and ventilate. He is treated with intravenous immunoglobulin.
When would you consider performing a tracheostomy?
Thank you for yesterdays contributions.
You are called to attend urgently because the patient has become agitated, hypertensive and acutely hypoxic. A tracheostomy was inserted 12 hours ago with no complications.
What would you do as you arrive? What are your initial thoughts?
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