TUBES AND LINES
INTUBATION WITHIN A CRITICAL CARE ENVIRONMENT
You may see patients who undergo endotracheal intubation during your attachment. Due to their critical illnessess, intubation in critically ill patients is associated with an increased risk of morbidity and mortality when compared to intubation for an elective surgical procedure.
Watch the video below for a demonstration of the process of intubation. How does the video compare to your experience of watching patients be intubated within a critical care environment?
Video Credit : New England Journal of Medicine
TUBES AND LINES
LINE INSERTION WITHIN CRITICAL CARE
Most patients within critical care have invasive lines placed as part of their care.
Arterial lines provide beat to beat, invasive blood pressure measurement and allow for repeated sampling of arterial blood to aid in the adjustment and weaning of ventilation, alongside routine blood tests.
Central lines are generally inserted into the internal jugular, subclavian or femoral veins. They can be inserted for a number of reasons. The most common indication for central line insertion is to enable infusions of drugs that cannot be given through peripheral routes (such as vasopressors and TPN).
Central venous access is also commonly obtained within critical care to allow facilitation of renal replacement therapy.
Almost all arterial line insertions and central line insertions make use of the Seldinger technique.
Watch the videos below and familiarise yourself with the technique prior to your attachment.
It is highly likely that you will have the opportunity to observe line placement in real time during your attachment.
Video Credit : EMCrit Video Credit : Yale School of Medicine
© Gilly Fleming/ NHS Lothian MED, 2020. All rights reserved