Airway Management: The Case for Routine Video-laryngoscopy

An adequate airway management plan is essential for patient safety. Recently, new tools have been developed as alternatives to direct laryngoscopy and intubation. These new tools need to be evaluated in terms of efficacy and the cost-effectiveness. One of these new devices, video-laryngoscopy has enjoyed a rapid increase in popularity and is now considered by many as the first-line technique in airway management which may have significant impact on patient safety.

 

Ventilator-associated Pneumonia:  Barriers to Best Practices

Ventilator-associated pneumonia (VAP) is a type of hospital-acquired infection that typically develops after more than 48 hours of mechanical ventilation. VAP is a common and serious problem in the intensive care unit that is associated with an increased risk of death.  Additionally, VAP significantly contributes to additional healthcare costs, mainly associated to longer ICU and hospital stay. This webinar will address the best practices for preventing VAP and exam the barriers to implementation

 

Reflux Disease: What We Are Doing. What We Could Be Doing 

Given the high prevalence of gastroesophageal reflux disease (GERD) and the various complications which can result from inadequate treatment, it is important for practitioners to have a proper understanding of the current approach to its diagnosis and management. This presentation will review the pathophysiology of GERD and associated symptoms. Traditional and novel technologies to diagnose  GERD and Barrett’s esophagus will be discussed, along with the importance of pH monitoring as both a diagnostic and therapeutic modality. Lastly, the range of treatment options for chronic reflux will be discussed.

Opioid-Free Anesthesia

The use of opioids in modern anesthesia has been an article of faith for more than a century. Opioid-free anesthesia (OFA) can be considered heresy that challenges the current thinking by providing improved patient outcomes for nearly 30 years. Opioid-inclusive anesthesia not only fails to prevent postoperative pain, but also increases postoperative nausea and vomiting, respiratory depression, and opioid rescue. Sedated patients breathe spontaneously and can move. This presentation focuses on OFA for IV sedation and applies OFA principles applicable to general anesthesia.

 

Tracheostomy: Review and choice of tube technology, adverse events, and care

With an emphasis on prevention of ventilator associated pneumonia, this webinar will focus on the components of a tracheostomy tubes including the different tube materials such as, cuffed, cuffless, fenestrated tracheostomy tubes, SSD and others. Considerations for how to choose the right tracheostomy technology for the right patient will also be presented.  Common adverse events, including respiratory infections will be discussed.  Finally, an evidence-based overview of up-to-date tracheostomy care will be presented.

Endotracheal Tubes and Tracheostomy Technology

Endotracheal intubation may be required when respiratory distress or airway integrity cannot be achieved or maintained for any reason. In the second webinar of this series on endotracheal airway management, our speaker will describe the different endotracheal tube technologies specifically examining the various structures and differences among them. This webinar will also analyze how to choose the right device in different scenarios. Finally, there will be a discussion the role of evacuation systems as mechanisms for clearance of subglottic secretions.

Respiratory Compromise: Risk Prediction on the General Care Floor

Opioid-induced respiratory depression (OIRD), a form of respiratory compromise, is one of the leading avoidable patient safety issue. Respiratory compromise, increases morbidity and mortality as well hospital inpatient costs. This presentation will discuss the results of a recent, multi-center study PRODIGY designed to identify people at high risk for OIRD. Results showed that more than 40% of patients on the general care floor experienced OIRD. The investigators will share an easy-to-use risk prediction tool they developed to identify patients at high risk that can lead to earlier interventions.

 

Bundling Care to Enhance Readiness to Wean

In ICUs across the US, clinicians are working to ensure the ABCDF bundle is fully integrated into daily care. Over the last decade, concentrated effort has occurred to Awaken patients through use of sedation protocols, facilitating ventilator liberation through spontaneous Breathing trials, Coordination of complex interdisciplinary care, evaluating and managing Delirium in order to foster successful progressive Early mobilization with patient and Family engagement.  Without successful bundling of the interventions, the ability to liberate a patient from the ventilator is significantly more challenging. Physicians, nurses and RTs working with an ICU patient have a unique as well as collaborative role in helping to achieve successful patient outcomes. This session will provide an overview of ABCDEF bundle to help demonstrate the impact these interventions have on increasing the readiness for a critically ill patient to be liberated from 

 

Liberation from mechanical ventilation: Can telehealth help expedite?

Liberation from mechanical ventilation is not a “cut and dried” process.  Clinicians need to be able to recognize patient’s rediness for ventilator separation and extubation.  Spontaneous Breathing Trials (SBTs) are the accepted method of assessment, but not always predictive.  In this webinar, there will be a discussion of the evidence for SBTs and of the role of automated weaning protocols. 

 

The Link Between Sedation & Asynchrony

While ventilation may be a life-saving tool for critically ill patients, it can also be an uncomfortable experience due to the invasiveness of the tubing, and mismatches (or “asynchronies”) between the patient’s demand for breath and the ventilator-delivered breathing pattern. In the past, clinicians addressed ventilator-patient asynchrony through heavy sedation. However, recent studies have highlighted the negative consequences of over-sedation for ventilatory patients, which include muscle atrophy from prolonged disuse and lengthened ventilation times. By evaluating for asynchrony, clinicians may be able to reduce the risk of oversedation. By using sedation more effectively, we can work together to potentially reduce ICU ventilation time.

 

Common, Costly and Deadly: Respiratory Compromise 

Respiratory compromise (RC) is a critical postoperative complication that increases the likelihood of adverse outcomes and the cost of care. Several trials have confirmed that patient observation continues to underestimate the overall incidence of postoperative RC. This CE webinar will review the evidence and provide recommendations for the prevention of RC.

 

Identifying Postoperative Respiratory Compromise: Comprehensive Assessment of Ventilation and Oxygenation.

There is compelling evidence that continuous monitoring of the respiratory function has a significant impact on clinical outcomes and cost of care. Although ventilation and oxygenation are different physiologically, it is recommended that they be monitored togeher and continuously to prevent postoperative respiratory compromise.

 

Early Warning Systems: Early Identification of the Deteriorating Patient

Early Warning Scoring (EWS) systems provide a commonly understood way to recognize the degree of deterioration in a patient’s status, and can ensure that every patient is seen at the right time by the right person. The EWS is based on the collection of a combination of vital signs including heart rate, respiratory rate, oxygen saturation, blood pressure and body temperature. In this webinar, there will a discussion of the benefits, variations and strategies for overcoming barriers to successful implementation of EWS in hospitals.

“A long day’s journey into life.” Using Prediction Methodologies to Prevent Decompensation and Death

Early detection of clinical deterioration and timely escalation are critical for improving patient safety and preventing subsequent events in hospitals/acute care settings. Based on two patient case studies, this webinar will take you on the clinical journey of spiraling decompensation towards the final possible destination, death. Using evidence-based strategies to guide monitoring and intervention, this presentation will emphasize astute awareness and valuable notification using a focused algorithms.

 

Crohn's Disease:Diagnosis, Treatment, and Monitoring Description:

Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract characterized by inflammation at any point from the mouth to the rectum. This webinar will discuss the pathways to diagnosis, treatment, and monitoring of both suspected and known Crohn’s disease of the small bowel and colon, utilizing society guidelines and new evidence-based clinical data.  Steps to determining a diagnosis, staging, diagnostic testing modalities, treatment pathways and evaluation of mucosal healing in response to treatment using scoring test and imaging modalities will be covered.

 

Gastroesophageal Reflux Disease: Diagnostic Paradigms

Given the high prevalence of gastroesophageal reflux disease (GERD) and the various complications which can result from inadequate treatment, it is important for practitioners to have a proper understanding of the current approach to its diagnosis and management. This webinar  presented by a leading expert in GI disorders, will provide an update of the current diagnostic paradigms  for GERD  including, esophageal pH testing and interpretation, motility testing, and patient management.   

 

Monitoring Regional Oxygen Saturation: Assessing the Value of NIRS in Clinical Practice

Conventional cardiovascular monitoring may not detect tissue hypoxia, and conventional cardiovascular support aiming at global hemodynamics may not restore tissue oxygenation.  This webinar will review the use of Near-Infrared Spectroscopy Systems (NIRS) to detect cerebral desaturation and how guided detection and correction of cerebral desaturation may assist clinicians in reducing the perioperative incidence and depth of cerebral desaturation and improving postoperative outcomes in the cardiovascular surgery.

Derivation and Validation of a Novel Opioid-Induced Respiratory Depression Risk Prediction Tool

Opioid-induced respiratory depression (OIRD), a form of respiratory compromise, is one of the leading avoidable patient safety issues. Respiratory compromise increases morbidity and mortality as well hospital inpatient costs. This presentation will discuss the results of a recent, multi-center study (PRODIGY, a Medtronic-sponsored study), which was designed to identify people at high risk for OIRD. Results showed that more than 40% of patients on the general care floor experienced OIRD. The investigators will share an easy-to use risk prediction tool they developed to identify patients at high risk that can lead to earlier interventions.