Contraindications and Precautions

Question 1

Name the precuations fo using invasive suction for NP and Guedels

Answer 1

• # of the nose and face and base of the skull
• mouth and neck and oesophagus surgery
• laryngospasm
• glottis oedema
• coagulopathies
• bronchospasm
• tracheitis

Question 2

name the contraindications for Guedels and Yankauer

Answer 2

• hypersensitive gag reflex
• coaguopathies
• bronchospasm
• tracheitis

Question 3

What are the contraindications for Hyperinflation?

Answer 3

• recent oesophageal or lung surgery
• pneumothorax
• if there is an air lea n the ICC of a drained pneumothorax
• Undrained pneumothorax
• Bronchopulmonary fistula
• ARDS: affects long term outcomes

Question 4

List the precautions for hyperinflation

Answer 4

• unstable CV systems
• bronchospasm
• PEEP > 15
• Pt is PEEP dependent or high risk of de- recruitment if disconnected from the ventilator
• pressure support + PEEP > 30
• FiO2 >60%
• PIP >35
• Raised or unstable ICP
• Florid APO
• Restrictive or obstructive lung disease
• significant pulmonary hypertension or right ventricular dysfunction

Question 5

Name the Contraindications for NIV

Answer 5

• Respiratory arrest
• Life threatening hypoxaemia
• fixed obstruction of the upper airway
• Uncontrolled ischemia or arrythmias
• systolic BP < 90
• severely depressed LOC
• Unable to protect airway
• inability to clear secretions
• recent facial or upper airway surgery
• extensive facial lacerations or burns
• unstable facial fractures
• CSF leak
• Vomiting
• Undrained pneumothorax

Question 6

What are the precautions for Non incasive ventilation

Answer 6

• copious secretions
• sever comorbidity
• confusion and or agitations
• bowel obstruction
• GI surgery
• Focal consolidation on CXR

Question 7

Name the contraindications for mobilisation of an ICU patient

Answer 7

• high dose inotropes/ vasopressors
• unstable arrythmias
• acute myocardial infarction
• presence of IABP/ LVAD, pulmonary catheter any significant blood loss of new decrease in CO
• unstable ICP
• Spinal cord injury
• presence of drains
• uncontrolled seizures
• any large drop in GCS
• threatened airway
• large PTX/ effusion waiting drainage
• dramatic trauma to abdomen
• ortho fracture stabilisation
• paralysis/ muscle relaxant
• high risk or evidence of bleeding

Question 8

name the precautions to mobilisaing a patient in ICU

Answer 8

• prone positioning: min of 6 people needed
• imminent extubation
• specific amounts of respiratory support
• baseline RR/ Dyspnoea
• palliation