Covid 19 Airway Management And Ventilation Strategy For Critically Ill Older Patients

This book describes the issues and challenges that clinicians encountered in the management of older critically ill patients during the Covid-19 pandemic, and offers practical information on how to manage them. Older adults are more susceptible to complications such as acute respiratory distress syndrome (ARDS) as a result of viral pneumonia. In addition, they often have multiple comorbidities and are commonly frail, which means their various organs and systems, such as the respiratory system, have reduced functional reserves. As such, older adults are less able to react to acute stressors. During the current Covid-19 pandemic, older adult patients' mortality is increased. Further, the infection and death rates of elderly people in nursing homes and health care institutions are high. Management of older adults with Covid is complicated. The reduced availability of beds may limit their access to ICU. Moreover, the prognosis may be poor, and airway management and ventilation strategies have to take into account various clinical and physiological characteristics specific to older patients. This book is addressed to all allied professionals involved in the management of older critically ill patients and presents information collected and practical lessons learned from the clinical daily management of this population during the pandemic.

The second edition of this book describes the clinical indications of NIV in patients hospitalized with high-risk infections as well as in the prehospital management of mass casualty incidents, including chemical or biological disasters and pandemics. In recent decades, we have learned the impact that different pandemics and mass casualty disasters can outcome in terms of health resource use, health costs and human lives. The development of respiratory failure in these patients, either infectious or non-infectious causes, has led to develop employment plans related both to invasive or noninvasive mechanical ventilation during acute respiratory failure. In this book authors evaluate a rational basis for indications, specific noninvasive mechanical ventilation indications in hospitalized patients (tuberculosis, bacterial, virus, etc.) and prehospital applications (mass casualty: chemical, biological disaster), equipment (ventilators, interfaces) and plan organization for health systems: how and when apply NIV. A critical review of already published studies is described as well as implications and how will be the future according to international expert opinions. Therefore, this updated edition represents a useful scientific reference point according to what it has been experienced in the last pandemics, with respect to the growing role that NIV has and must have in the world.

Now in paperback, the second edition of the Oxford Textbook of Critical Care is a comprehensive multi-disciplinary text covering all aspects of adult intensive care management. Uniquely this text takes a problem-orientated approach providing a key resource for daily clinical issues in the intensive care unit. The text is organized into short topics allowing readers to rapidly access authoritative information on specific clinical problems. Each topic refers to basic physiological principles and provides up-to-date treatment advice supported by references to the most vital literature. Where international differences exist in clinical practice, authors cover alternative views. Key messages summarise each topic in order to aid quick review and decision making. Edited and written by an international group of recognized experts from many disciplines, the second edition of the Oxford Textbook of Critical Careprovides an up-to-date reference that is relevant for intensive care units and emergency departments globally. This volume is the definitive text for all health care providers, including physicians, nurses, respiratory therapists, and other allied health professionals who take care of critically ill patients.

This book assesses the most appropriate forms of aerosol therapy for critically ill patients. Aerosol therapy is applied for the treatment of several pulmonary diseases in addition to some promising applications intended for systemic absorption. Nowadays, aerosol delivery to clinically stable patients in the outpatient settings is done easily with a lot of focus on patient counseling and enhancement of lung deposition. A lot of guidelines are available for several diseases and it could offer adequate guidance to the therapists concerning escalation or de-escalation of therapy to enhance treatment efficiency and safety. However, in critically ill patients aerosol delivery is mostly done by the choice of the respiratory therapist only according to his knowledge. The book describes the type of patients requiring aerosol therapy, different aerosol generators available for the treatment of critically ill patients, mechanisms of aerosol lung deposition, and factors affecting aerosol deposition. It also discusses the special needs of neonates and infants, transitioning aerosol from hospital to home, and the methods of aerosol delivery to different patient e.g. nasal delivery patients, ventilated patients, etc. Moreover, it reviews methods of detecting such aerosol delivery to the lung. At the end, it discusses the suggested monitoring plans and weaning protocols to ensure high efficacy and safety of the ventilatory support in such patients. Given its scope, the book can serve as guidelines or specific recommendations to maximize clinical benefits of medicated aerosols in critically ill patients and it represents a valuable resource for intensivists, pulmonologists and healthcare professionals working at ICUs.

In different sections of this book the relationships between the patterns of psychological response in acute and chronic respiratory failure, as well as the epidemiology of neuropsychiatric disorders in ventilator management, are collected and analyzed. Main concepts such as “vulnerability to stress”, critical illness-psychological stress and susceptibility that may develop during NIV support, as well as the diagnosis of neuropsychiatric disorders in respiratory failure are also summarized. A section is devoted to the most frequent indications of NIV, also including a special use of NIV in pandemic and high-risk infections, as well as in several other conditions such as acute and chronic respiratory failures and neurological disorders. A summary of practical approaches for treatment and prevention in neurologic and psychiatric disorders during noninvasive mechanical ventilation, as well as the perspective in terms of outcomes, quality-of-life, palliative care is also given. The book is intended for all those healthcare professionals treating patients suffering from neurological or psychiatric disorders and who develop acute or chronic respiratory failure. Neurologists, psychiatrists, pulmonary critical care professionals, geriatricians, internists and psychologists will find in the book a valuable guide for their everyday clinical practice.

This book provides a concise yet comprehensive overview of pediatric acute respiratory distress syndrome (PARDS). The text reviews the emerging science behind the new PARDS definition; explores epidemiology, pathobiology, etiologies, and risk factors; reviews state-of-the-art treatment modalities and strategies; and discusses clinical outcomes. Written by experts in the field, Pediatric Acute Respiratory Distress Syndrome: A Clinical Guide is a valuable resource for clinicians and practitioners who specialize in pediatric critical care.

The influenza pandemic caused by the 2009 H1N1 virus underscores the immediate and critical need to prepare for a public health emergency in which thousands, tens of thousands, or even hundreds of thousands of people suddenly seek and require medical care in communities across the United States. Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations draws from a broad spectrum of expertise-including state and local public health, emergency medicine and response, primary care, nursing, palliative care, ethics, the law, behavioral health, and risk communication-to offer guidance toward establishing standards of care that should apply to disaster situations, both naturally occurring and man-made, under conditions in which resources are scarce. This book explores two case studies that illustrate the application of the guidance and principles laid out in the report. One scenario focuses on a gradual-onset pandemic flu. The other scenario focuses on an earthquake and the particular issues that would arise during a no-notice event. Outlining current concepts and offering guidance, this book will prove an asset to state and local public health officials, health care facilities, and professionals in the development of systematic and comprehensive policies and protocols for standards of care in disasters when resources are scarce. In addition, the extensive operations section of the book provides guidance to clinicians, health care institutions, and state and local public health officials for how crisis standards of care should be implemented in a disaster situation.

Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources. Crisis Standards of Care: A Toolkit for Indicators and Triggers examines indicators and triggers that guide the implementation of crisis standards of care and provides a discussion toolkit to help stakeholders establish indicators and triggers for their own communities. Together, indicators and triggers help guide operational decision making about providing care during public health and medical emergencies and disasters. Indicators and triggers represent the information and actions taken at specific thresholds that guide incident recognition, response, and recovery. This report discusses indicators and triggers for both a slow onset scenario, such as pandemic influenza, and a no-notice scenario, such as an earthquake. Crisis Standards of Care features discussion toolkits customized to help various stakeholders develop indicators and triggers for their own organizations, agencies, and jurisdictions. The toolkit contains scenarios, key questions, and examples of indicators, triggers, and tactics to help promote discussion. In addition to common elements designed to facilitate integrated planning, the toolkit contains chapters specifically customized for emergency management, public health, emergency medical services, hospital and acute care, and out-of-hospital care.