Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update

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Galloway JA, Bressler R. Thiamine destruction by sodium bisulfite in infusion solutions. Ports are typically used on patients requiring only occasional venous access over a long duration course of therapy. Knowledge and perception of diabetes mellitus management among patients in Implementing a ventilator care bundle in an adult intensive care unit. Estas pautas son apropiadas para el paciente séptico hospitalizado. This page was last edited on 5 September , at

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Shoulder pain radiating down the arm DDX. Serious skin signs in sick patients DDX, infarcts, pupura, rash, blisters, vesicles, oral lesions, exfoliatve, pustules, scaling, wheals, facial edema, oedema. Hirsutism, abnormal hair growth. Diffuse goitre, thyroid, enlarged, enlargement. Abdominal pain, acute abdomen, tenderness, rigidity. Groin lump, hernia, swelling, mass. Hepatomegaly, liver, enlarged, enlargement. Large bowel obstruction DDX. Liver palpation abnormalities, firm and irregular liver, tender liver, pulsatile liver.

Medical causes of abdominal pain. Small bowel obstruction DDX. Anaphylaxis, severe allergic reaction. Laboratory urinalysis, casts, microscopy, culture. Dipstick urinalysis, bedside, protein, blood, glucose, leukocyte esterase, nitrites, ketones, bilirubin, urobilinogen, nitrites, specific gravity. Urine colour, color, urinalysis. Urine electrolytes, sodium, anion gap.

Urine odour, odor, urinalysis. Urine transparency, turbidity, urinalysis. Thyroid Function Tests, hypothyroidism, hyperthyroidism. Bilirubin, jaundice, conjugated, unconjugated. Paracentesis Ascitic Tap , ascites, exudate, transudate, serum: Anemia, anaemia, hypochromic, normochromic, normocytic, macrocytic, microcytic, iron studies. CSF analysis, lumbar puncture, meningitis.

Acid-Base disorders, approach, osmolar gap. Joint fluid analysis, arthrocentesis, crystals, microscopy, white cells. Pleural Fluid Analysis, exudate, transudate, gradient, ratio. Hilar enlargement on chest x-ray DDX. Pseudoinfiltrates on chest x-ray DDX. Pulmonary opacities on chest x-ray DDX, consolidation, airspace filling, nodular, reticular, reticulonodular. Ammonia and hyperammonaemia, hyperammonemia. Bulbar palsy, pseudobulbar palsy.

Central Pontine Myelinolysis, extrapontinemyelinolysis, osmotic demyelination syndrome. Cranial nerve lesions, palsy, 3, 4, 6, 11, 12, multiple. Facial twitches DDX, recurrent, hemifacial spasm.

Movement disorders DDX, hypokinesia, hyperkinesia. Radiculopathy DDX, nerve root. Seizures, epilepsy, status epilepticus, seizure mimics. Sudden severe headache DDX, thunderclap, abrupt onset. Asterixis DDX, hepatic flap. Wasting of the small muscles of the hand. Blepharospasm, blinking, facial tics. Eye trauma, blunt, penetrating.

Fixed dilated pupil, mydriasis, blown pupil. Loss of vision, visual loss, blindiness. Optic disk abnormality, papiloedema, optic atrophy, papillitis. Red eye, painful, painless. Pseudofractures DDX, fracture mimics. Kidney mass, renal mass, enlarged kidney. Airway obstruction, incomplete, partial, complete. Atelectasis, lung collapse, collapsed lung. High airway pressures, intubated, ventilated.

Massive haemoptysis DDX, hemoptysis. Hilar Adenopathy DDX, hilum, lymph, node, gland. Toxic agents and abnormal vital signs. Toxicological causes of cardiac arrest.

Acute Myocardial infarction echocardiography. Echocardiography in Intensive Care. LV function echocardiography, left ventricular, assessment. RV function echocardiography, right ventricular, assessment. Calcium replacement advantages and disadvantages.

Hyperkalaemia management, hyperkalemia, potassium. Magnesium, hypermagnesaemia, hypomagnesaemia, hypermagnesemia, hypomagnesemia. Calcium as an inopressor. Glucose control literature summaries. Glycemic control in critical care. Oxidative stress in critical illness. Thyroid storm, hyperthyroidism, thyrotoxicosis. Ludwig's Angina, submandibular space. Arterial line, IABP, intra-arterial blood pressure. BIS Monitor, depth of anaesthesia, bispectral index.

Blood Culture Bottles, Collection. Blood Gas Analyser, machine, arterial, venous. Capnography and CO2 detectors, carbon dioxide. Chest Drainage System, underwater seal. Codman ICP Monitor, bolt.

Defibrillation pads and paddles. Endotracheal Tube, double lumen, DLT. Electrical Concepts and Definitions. Flexible bronchoscope, Fiberoptic, Video. Heat and Moisture Exchanger. Indications for Extracorporeal Therapies.

Jugular Bulb Oxygen Saturation. Nerve stimulator, train of four. Non-rebreathing Oxygen Mask, Partial rebreathing. Pulmonary Artery Wedge Pressure and Wedging. Pulse Oximeter, Pulse Oximetry. Regional Anaesthesia in the Critically Ill. Regulator for Medical Suction Outlet. RIC Line, rapid infusion catheter. Central venous oxygen saturation ScvO2 monitoring. Senkstaken-Blackmore and Minnesota Tubes. Site of Temperature Measurement in the Critically Ill. SvO2 vs ScvO2, venous oxygen saturation, central versus pulmonary.

Mixed venous oxygen saturation SvO2 monitoring. Temporary Epicardial Cardiac Pacing. Temporary Transvenous Cardiac Pacing. Testing Gas Supply and Suction. Tiger tube, self-advancing nasal jejunal enteric feeding. Dialysis catheter, vascath, access for RRT, renal replacement therapy. Warming blanket, Bair hugger, patient warming system. Cricothyroidotomy kits Melker, Rush Quicktrach. Swedish nose, Tracheostomy Heat and Moisture Exchanger. History of the Pulmonary Artery Catheter. Autotransfusion device and cell salvage, cell saver, chest tube.

Endotracheal suction and catheter. Albumin versus normal saline. Fluid Therapy Literature Summaries. Glycocalyx in Critical Illness. Deresuscitation, de-resuscitation and positive fluid balance. Fluid balance, daily, cumulative, assessment, chart. Fluid administration device flow rates. Fluid bolus therapy, sepsis. Abnormal LFTs post-vascular surgery. Coagulopathy in liver dysfunction. GI haemorrhage, bleeding, gastrointestinal, upper, lower, hemorrhage.

Liver failure definitions and scoring systems. Clostridium difficile Enterocolitis and Pseudomembranous Colitis. Spontaneous bacterial peritonitis, SBP. Gastric Residual Volume, enteral feeding, intolerance. Gastrointestinal dysfunction in the critically ill, GI, gut, failure. Animal encounters and disease. Clinical examination of the critically ill. Double peak on arterial pulse.

Surgical and Procedural scars, hot case, clinical examination, differential diagnosis. Problems after bariatric surgery. The open abdomen, management. Elder abuse, elderly, neglect. Post-Thrombolysis Haemorrhage, bleeding after. Thrombocytopaenia-associated MODS, multiple organ dysfunction syndrome. Haemolytic anaemia, anemia, hemolytic, haemolysis, hemolysis.

Oozing from a Venepuncture Site. Sickle cell crisis, disease, anaemia, anemia, acute chest syndrome, vaso-occlusive disease, acute splenic sequestration, aplastic, priapism. Thrombocytopaenia, thrombocytopenia, low platelets.

Differentiation syndrome, Retinoic acid syndrome. Informed Consent for Blood Transfusion. Blood Transfusion in ICU. Leukodepleted Blood, RBC, red blood cells.

TRALI, transfusion related lung injury. Reversal of anti-platelet agents, reversing, clopidogrel, aspirin. Hemophagocytic Lymphohistiocytosis HLH , syndrome, haemophagocytic. Rivaroxaban, haemorrhage, bleeding, toxicity, NOAC. AAA repair hot case, abdominal aortic aneurysm. Bariatric patient hot case, obesity. Brain death hot case. Burns patient hot case. Cardiac arrest survivor hot case. COPD hot case, emphysema, chronic obstructive pulmonary disease. Extubation assessment hot case. Fever hot case, sepsis.

Head injury patient hot case. General approach to the hot case. Intra-abdominal catastrophe hot case, acute abdomen. Long stay patient hot case. Neutropenic fever hot case.

Obstetric patient hot case. Oliguria and anuria hot case. Post cardiac surgery hot case. Respiratory failure hot case. Spinal injury patient hot case. Subarachnoid haemorrhage hot case. Tracheostomy ready for decannulation hot case. Maximal Sterile Barrier Bedside Tray. Mixter Endoscopic Cholangiography Set.

Modified Novy Cornual Cannulation Set. Mouse Tooth Retrieval Forceps. Multi-Sideport Catheter Infusion Set. Multipurpose Plastic Tubing Adapter. Multipurpose Drainage Catheter Set. NGage Salivary Stone Extractor. Nasal Biliary Drainage Sets. Nasal Pancreatic Drainage Set. Neff Percutaneous Access Set. Olsen Endoscopic Cholangiography Set. One-Part Percutaneous Entry Needle.

Park Blade Septostomy Catheter. Percutaneous Neonatal Pigtail Nephrostomy Set. Pericardiocentesis Tray Pigtail Catheter. Peritoneal Dialysis Catheter Introduction Stylet. Peritoneal Lavage Set and Tray. Petelin Endoscopic Cholangiography Set. Pigtail Ureteral Catheter Set. Pivet Embryo Transfer Catheter Set. Rat Tooth Retrieval Forceps. Renal Access Cobra Catheter. Reuter Tip-Deflecting Wire Guide. Ring Biliary Duct Drainage Catheter. Ring Drainage Catheter Needle Set.

Ring Transjugular Intrahepatic Access Set. Rutner Universal Wedge Catheter. Safety Wire Guide Introducer Set. Salivary Access Dilator Set.

Salle Intraoperative Pyeloplasty Stent Set. San Antonio Stopcock with Modified Fitting. Shepard Intrauterine Insemination Set. Colorectal Surgery, Gastroenterology, General Surgery. Soft-Shaft Malecot Drainage Catheter. Tenckhoff Acute Peritoneal Dialysis Catheter. Tenckhoff Chronic Peritoneal Dialysis Catheter. Thal-Quick Abscess Drainage Set. Thal-Quick Chest Tube Adapter. Thoracentesis Set - Polyurethane.

Towako Transmyometrial Embryo Transfer Set. Tunner Pediatric Urethral Dilator Set. Turner Pigtail Pneumothorax Set. In the management of acute pancreatitis, the treatment is to stop feeding the patient, giving them nothing by mouth, giving intravenous fluids to prevent dehydration , and sufficient pain control.

As the pancreas is stimulated to secrete enzymes by the presence of food in the stomach, having no food pass through the system allows the pancreas to rest. The incidence of relapse after oral refeeding may be reduced by post-pyloric enteral rather than parenteral feeding prior to oral refeeding.

Recently, there has been a shift in the management paradigm from TPN total parenteral nutrition to early, post-pyloric enteral feeding in which a feeding tube is endoscopically or radiographically introduced to the third portion of the duodenum.

The advantage of enteral feeding is that it is more physiological, prevents gut mucosal atrophy, and is free from the side effects of TPN such as fungemia. The additional advantages of post-pyloric feeding are the inverse relationship of pancreatic exocrine secretions and distance of nutrient delivery from the pylorus, as well as reduced risk of aspiration. Disadvantages of a naso-enteric feeding tube include increased risk of sinusitis especially if the tube remains in place greater than two weeks and a still-present risk of accidentally intubating the trachea even in intubated patients contrary to popular belief, the endotracheal tube cuff alone is not always sufficient to prevent NG tube entry into the trachea.

Up to 20 percent of people with acute pancreatitis develop an infection outside the pancreas such as bloodstream infections, pneumonia, or urinary tract infections. However, if cultures are negative and no source of infection is identified, antibiotics should be discontinued. Preventative antibiotics are not recommended in people with acute pancreatitis, regardless of the type interstitial or necrotizing or disease severity mild, moderately severe, or severe [46] [47].

Endoscopic retrograde cholangiopancreatography ERCP , performed within 24 to 72 hours of presentation, is known to reduce morbidity and mortality. Surgery is indicated for i infected pancreatic necrosis and ii diagnostic uncertainty and iii complications. The most common cause of death in acute pancreatitis is secondary infection. Infection is diagnosed based on 2 criteria. In the United States, the annual incidence is 18 cases of acute pancreatitis per , population, and it accounts for , hospitalizations in the US.

In Western countries, the most common cause is alcohol, accounting for 65 percent of acute pancreatitis cases in the US, 20 percent of cases in Sweden, and 5 percent of those in the United Kingdom. The causes of acute pancreatitis also varies across age groups, with trauma and systemic disease such as infection being more common in children.

Mumps is a more common cause in adolescents and young adults than in other age groups. From Wikipedia, the free encyclopedia. Acute pancreatitis Synonyms Acute pancreatic necrosis [1] Pancreas Specialty Gastroenterology , general surgery Acute pancreatitis is a sudden inflammation of the pancreas pancreatitis.

American Journal of Nursing. Archived from the original on Early complications of severe acute pancreatitis. The American Journal of Gastroenterology. A new index that distinguishes acute episodes of alcoholic from nonalcoholic acute pancreatitis". ANZ Journal of Surgery. A study of sensitivity and specificity".

Annals of Internal Medicine. Their diagnostic value for acute pancreatitis". Journal of Clinical Gastroenterology. Without support for the superiority of the lipase: Clinical Chemistry and Laboratory Medicine. A prospective clinical study". Digestive and Liver Disease. American Journal of Roentgenology. Digestive Diseases and Sciences. World Journal of Gastroenterology.

Journal of the American College of Surgeons. European Journal of Radiology. Clinical Gastroenterology and Hepatology. The Cochrane Database of Systematic Reviews. The British Journal of Surgery. American Journal of Surgery. The Intensive Care Manual. William Schwab; Donald M. Trauma and Acute Care Surgery. The New England Journal of Medicine.

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