scholarly journals Iatrogenic Esophagopleural Fistula After the Management of Acute Variceal Hemorrhage With Minnesota Tube Placement

2021 ◽  
Vol 9 (1) ◽  
pp. e00714
Author(s):  
Rachel V. White ◽  
Roland Y. Lee ◽  
Benjamin J. Shin ◽  
James H. Birkholz
Keyword(s):  
Tube Placement ◽  
Variceal Hemorrhage

Passy-Muir Speaking Valve Use in a Children's Hospital: An Interdisciplinary Approach

2008 ◽  
Vol 18 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Lauren Hofmann ◽  
Joseph Bolton ◽  
Susan Ferry
Keyword(s):  
Tracheostomy Tube ◽  
Pediatric Population ◽  
Interdisciplinary Approach ◽  
Extended Period ◽  
Speech Development ◽  
Tube Placement ◽  
Background Information ◽  
Speaking Valve ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

Proof of concept study using a modified Politzer inflation device as a rescue modality for treating Eustachian tube dysfunction during hyperbaric oxygen treatment in a multiplace (Class A) chamber

2019 ◽  
pp. 55-61
Author(s):  
Owen J. O’Neill ◽  
Elizabeth Smykowski ◽  
Jo Ann Marker ◽  
Lubiha Perez ◽  
drah Gurash ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Dysfunction ◽  
Tube Placement ◽  
Treatment Schedule ◽  
Surgical Interventions ◽  
Hyperbaric Treatment ◽  
Middle Ear Pressure ◽  
Tube Dysfunction

Introduction: Eustachian tube dysfunction (ETD) and middle ear barotrauma (MEB) are the most common adverse effects of hyperbaric oxygen (HBO2) treatments. Patients practice equalization maneuvers to prevent ETD and MEB prior to hyperbaric exposure. Some patients are still unable to equalize middle ear pressure. This ETD results in undesirable consequences, including barotrauma, treatment with medications or surgical myringotomy with tube placement and interruption of HBO2. When additional medications and myringotomy are employed, they are associated with additional complications. Methods: A device known as the Ear Popper® has been reported to reduce complications from serous otitis media and reduce the need for surgical interventions (myringotomy). Patients unable to equalize middle ear pressure during initial compression in the hyperbaric chamber were allowed to use the device for rescue. All hyperbaric treatments were compressed using a United States Navy TT9, or a 45-fsw hyperbaric treatment schedule. Patients with persistent ETD and the inability to equalize middle ear pressure were given the Ear Popper upon consideration of terminating their treatment. Results: The Ear Popper allowed all patients to successfully equalize middle ear pressure and complete their treatments. Conclusion: This study substantiates the use of this device to assist in allowing pressurization of the middle ear space in patients otherwise unable to achieve equalization of middle ear pressure during HBO2 treatment in a multiplace chamber.

The Esophageal Detector Device: Accuracy and Reliability in Difficult Airway Settings

1996 ◽  
Vol 11 (1) ◽  
pp. 60-62 ◽  
Author(s):  
Christopher E. Kapsner ◽  
David C. Seaberg ◽  
Charles Stengel ◽  
Kaveh Ilkhanipour ◽  
James Menegazzi
Keyword(s):  
Emergency Medicine ◽  
Pulmonary Edema ◽  
Difficult Airway ◽  
Laboratory Investigation ◽  
Respiratory Arrest ◽  
Tube Placement ◽  
Mainstem Bronchus ◽  
Anatomic Location ◽  
The Right ◽  
Attending Physician

AbstractIntroduction:The esophageal detector device (EDD) recently has been found to assess endotracheal (ET) tube placement accurately. This study describes the reliability of the EDD in determining the position of the ET tube in clinical airway situations that are difficult.Methods:This was a prospective, randomized, single-blinded, controlled laboratory investigation. Two airway managers (an emergency-medicine attending physician and a resident) determined ET-tube placement using the EDD in five swine in respiratory arrest. The ET tube was placed in the following clinical airway situations: 1) esophagus; 2) esophagus with 1 liter of air instilled; 3) trachea; 4) trachea with 5 ml/kg water instilled; and 5) right mainstem bronchus. Anatomic location of the tube was verified by thoracotomy of the left side of the chest.Results:There was 100% correlation between the resident and attending physician's use of the EDD. The EDD was 100% accurate in determining tube placement in the esophagus, in the esophagus with 1 liter of air instilled, in the trachea, and in the right mainstem bronchus. The airway managers were only 80% accurate in detecting tracheal intubations when fluid was present.Conclusions:The EDD is an accurate and reliable device for detecting ET-tube placement in most clinical situations. Tube placement in fluid-filled trachea, lungs, or both, which occurs in pulmonary edema and drowning, may not be detected using this device.

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