Critical Care

Ultrasound better than Chest X ray for post- central venous catheterization screening

central vein usg
Central venous catheterization is a common procedure done in the critical care units. The common indications include venous access, drug delivery, CVP measurement, total parenteral nutrition, shock management etc. As with any medical procedures, complication may occur after central venous cannulation.  Catheter tip misplacement, pneumothorax, arterial puncture, neural injury, hematoma are some of the reported complications. Catheter tip misplacement can cause thrombosis, arrhythmias, venous and...

Ultrasound Exam to Confirm ET Tube Position

Endotracheal intubation is one of the commonest procedures done in the emergency and critical care departments. Wrong placement of the ET tube into the esophagus occurs rarely. With the widespread use of videolaryngoscopy the vocal cords are easily visualized and the possibility of wrong placement is limited.  But the frequency of the wrong placement increases with inadequate operator expertise, difficult upper airway anatomy, difficult visualization of the upper airway due to fluid, blood or...

Ultrasound Evaluation in Acute Respiratory Failure - the BLUE protocol

Unlike abdominal and obstetrical ultrasound, thoracic ultrasound had been little late in becoming a widely used tool. But in the past two decades thanks to Dr.Lichtenstein and co-workers, it has become an essential and indespensible tool in the emergency and critical care units. Its easy availability at the bed side, lack of radiations, feasibility for multiple examinations over a time period, low cost and high sensitivity and specificity has broadened its applications in the evaluation of...

Presence of Specialist Round the Clock in an ICU does not improve Patient Survival

icu room
Many people as well as physicians believe that putting a specialist in the ICUs round the clock improves the rate of survival of the patients. However, a new study published in the New England Journal of Medicine has found that this is not necessarily true. If there is a specialist in the ICU during the day, putting an intensivist in the ICU does not have any impact on the survival of the patients. Earlier studies have shown that a specialist trained in critical care improves the outcome of the...

Non-Invasive Ventilation reduces the Stay of the Infant in the ICU

A recent study, published in the latest issue of the journal Intensive Care Medicine, has found that during the past decade, increased dependency on non-invasive ventilation for infants suffering from severe bronchiolitis, has been associated with reduced rate of intubation and a shortened stay of the infant in the ICU. For their study, the researchers analyzed the clinical database of a tertiary 23 bed pediatric intensive care unit (PICU). The records of all the infants admitted in the PICU...

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