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Author Giri, Paresh C. ♦ Bellinghausen Stewart, Amy ♦ Dinh, Vi A. ♦ Chrissian, Ara A. ♦ Nguyen, H. Bryant
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Sociology & anthropology ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Pharmacology and therapeutics ♦ Diseases ♦ Agriculture & related technologies
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Therapeutics ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Human Activities ♦ Anthropology, Education, Sociology and Social Phenomena ♦ Technology, Industry, and Agriculture ♦ Technology and Food and Beverages ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Care
Subject Keyword Discipline Critical Care ♦ Critical Care ♦ Methods ♦ Intensive Care Units ♦ Organization & Administration ♦ Tracheostomy ♦ Adult ♦ Aged ♦ Female ♦ Humans ♦ Male ♦ Middle Aged ♦ Quality Improvement ♦ Respiration, Artificial ♦ Education ♦ Work ♦ Journal Article
Abstract PURPOSE: Percutaneous dilatational tracheostomy (PDT) is increasingly becoming the preferred method, compared with open surgical tracheostomy, for patients requiring chronic ventilatory assistance. Little is known regarding the process involved to incorporate PDT as a standard service in the medical intensive care unit. In this report, we describe our experience developing a 'PDT service' led by medical intensivists. MATERIALS AND METHODS: With support from our leadership and surgical colleagues, we developed a credentialing and training process for medical intensivists, formulated a bedside team to perform PDT, refined our technique, and maintained a patient data registry for quality improvement. RESULTS: To date, our service includes 4 medical intensivists with PDT privileges. Over a 4-year period, we performed 171 PDTs for patients in the medical intensive care unit after 12.1 ± 8.2 days of mechanical ventilation. Our procedure-related complication rates are similar to other reports. No patient required emergent open surgical tracheostomy, and there were no deaths related to PDT. We required minimal to no backup support from our surgical colleagues in performing PDT. CONCLUSIONS: We successfully developed a medical intensivist-driven PDT service, sharing our unique successes and challenges, to facilitate the care of our patients requiring prolonged ventilator support.
Description Country affiliation: United States
Author Affiliation: Giri PC ( Department of Medicine, Pulmonary and Critical Care, Loma Linda University, Loma Linda, CA, USA.); Bellinghausen Stewart A ( Department of Medicine, Loma Linda University, Loma Linda, CA, USA.); Dinh VA ( Department of Medicine, Critical Care, Loma Linda University, Loma Linda, CA, USA); Chrissian AA ( Department of Medicine, Pulmonary and Critical Care, Loma Linda University, Loma Linda, CA, USA.); Nguyen HB ( Department of Medicine, Critical Care, Loma Linda University, Loma Linda, CA, USA)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2015-04-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 30
Issue Number 2


Source: WHO-Global Index Medicus