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Rosann Juska trauma-list@trauma.orgSun, 3 Mar 2002 19:57:03 -0800
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Oh ok Thanks for explaining that to me :)
=B8..=B7 =B4=A8=A8)) -:=A6:-
=B8.=B7=B4 .=B7=B4=A8=A8))
((=B8=B8.=B7=B4 ..=B7=B4 -:=A6:-=20
-:=A6:- ((=B8=B8.=B7=B4* =20
Rosann Juska
"We all take different paths in life, but no matter
where we go, we take a little of each other everywhere."
--- Tim McGraw
"The fate of the wounded rest
in the hands of the one that
applies the first dressing."
-- Nicholas Senn, 1896
----- Original Message -----=20
From: Keith D. Lamb=20
To: trauma-list@trauma.org=20
Sent: Sunday, March 03, 2002 11:40 AM
Subject: Re: (no subject)
Hi Rosann...
=20
We are talking about two different things. The "combative" that you =
refer to is used "mostly" by pre-hospital folks like yourself...and =
sometimes others...for difficult airway issues that prevent you from =
combitube with a traditional endotracheal tube.=20
=20
The Double lumen (tracheobroncheal) tube that I am talking about is =
intentionally placed in the main-stem bronchus (usually the left) in =
such a manner that each lung can be ventilated independent of each =
other. It is often used intra-operatively so that one lung can be =
"dropped" to make the surgical procedure easier to accomplish. It can =
also be used when a specific lung injury/pathology is heterogeneous so =
that different ventilation/protective strategies can be adopted for each =
lung. This is the "aspect" that I am interested in most. Thanks.
=20
keith
=20
=20
Keith D. Lamb RCP, RRT
Charge Respiratory Therapist
Christiana Care Hospital
Newark, Delaware
----- Original Message -----=20
From: Rosann Juska=20
To: trauma-list@trauma.org=20
Sent: Sunday, March 03, 2002 5:11 PM
Subject: Re: (no subject)
I love the Combi tube!!! I often use it instead of an oral or nasal, =
if the situation is right. You can not use it for persons under 5 foot, =
has a gag reflex, a person who had ingested a corrosive substance of =
someone with an esophageal disease such as Cancer, or severe upper =
airway bleeding b/c it will pass directly into the lungs once the cuff =
has closed off the esophagus. It can be inserted "blindly" which avoids =
improper placement. I am not sure if this answered your question, but if =
not I can try again!
=B8..=B7 =B4=A8=A8)) -:=A6:-
=B8.=B7=B4 .=B7=B4=A8=A8))
((=B8=B8.=B7=B4 ..=B7=B4 -:=A6:-=20
-:=A6:- ((=B8=B8.=B7=B4* =20
Rosann Juska
EMT-P/ER Tech/IC
"We all take different paths in life, but no matter
where we go, we take a little of each other everywhere."
--- Tim McGraw
"The fate of the wounded rest
in the hands of the one that
applies the first dressing."
-- Nicholas Senn, 1896
----- Original Message -----=20
From: Keith D. Lamb=20
To: trauma-list@trauma.org ; Respiratory Care Professionals World =
Forum ; ccm-l@list.pitt.edu=20
Sent: Sunday, March 03, 2002 7:58 AM
Subject: (no subject)
How often are folks intubating with double lumen endotracheal =
tubes and for what indications? I don't meant intra-op for thoracic =
surgery...but pre-op...or post-op...for specific injury/pathology and to =
facilitate independent lung ventilation.=20
=20
For what injury/pathology are you seeing this performed most =
often? Example parenchymal injury/pathology or bronchus =
injury.....fistula etc.=20
=20
When your patient IS intubated in this fashion and each lung is =
being ventilated independently.....what kind of strategy do you employ =
regarding ventilator modes. Do you synchronize or not. Do you attempt to =
use just a little bit of CPAP with the injured side...or some other =
strategy. Do you conventionally ventilate the healthy lung and "jet" or =
"oscillate" the injured lung? Does tracheal gas insufflation have a role =
in this setting? Any thoughts?
=20
keith
=20
Keith D. Lamb RCP, RRT
Charge Respiratory Therapist
Christiana Care Hospital
Newark, Delaware
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<DIV><FONT color=3D#008080 face=3D"Goudy Old Style">Oh ok Thanks for =
explaining that=20
to me :)</FONT></DIV>
<DIV><BR>=B8..=B7 =B4=A8=A8)) -:=A6:-<BR> =
=B8.=B7=B4=20
.=B7=B4=A8=A8))<BR> ((=B8=B8.=B7=B4 =
..=B7=B4 -:=A6:- <BR> =20
-:=A6:- ((=B8=B8.=B7=B4* =20
<BR> &nb=
sp; =20
Rosann Juska<BR>"We all take different paths in life, but no=20
matter<BR> where we go, we take a little of each other =
everywhere."<BR>---=20
Tim McGraw</DIV>
<DIV> </DIV>
<DIV>"The fate of the wounded rest<BR>in the hands of the one =
that<BR>applies=20
the first dressing."<BR>-- Nicholas Senn, 1896<BR></DIV>
<BLOCKQUOTE dir=3Dltr=20
style=3D"BORDER-LEFT: #008080 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: =
0px; PADDING-LEFT: 5px; PADDING-RIGHT: 0px">
<DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
<DIV=20
style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
<A href=3D"mailto:kdlamb@prodigy.net" title=3Dkdlamb@prodigy.net>Keith =
D. Lamb</A>=20
</DIV>
<DIV style=3D"FONT: 10pt arial"><B>To:</B> <A=20
href=3D"mailto:trauma-list@trauma.org"=20
title=3Dtrauma-list@trauma.org>trauma-list@trauma.org</A> </DIV>
<DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Sunday, March 03, 2002 =
11:40=20
AM</DIV>
<DIV style=3D"FONT: 10pt arial"><B>Subject:</B> Re: (no subject)</DIV>
<DIV><BR></DIV>
<DIV><FONT face=3DArial size=3D2>Hi Rosann...</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>We are talking about two different =
things. The=20
"combative" that you refer to is used "mostly" by pre-hospital folks =
like=20
yourself...and sometimes others...for difficult airway issues that =
prevent you=20
from combitube with a traditional endotracheal tube. </FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>The Double lumen (tracheobroncheal) =
tube that I=20
am talking about is intentionally placed in the main-stem bronchus =
(usually=20
the left) in such a manner that each lung can be ventilated =
independent of=20
each other. It is often used intra-operatively so that one lung can be =
"dropped" to make the surgical procedure easier to accomplish. It can =
also be=20
used when a specific lung injury/pathology is heterogeneous so that =
different=20
ventilation/protective strategies can be adopted for each lung. This =
is the=20
"aspect" that I am interested in most. Thanks.</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>keith</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV>Keith D. Lamb RCP, RRT</DIV>
<DIV>Charge Respiratory Therapist<BR>Christiana Care =
Hospital<BR>Newark,=20
Delaware</DIV>
<BLOCKQUOTE dir=3Dltr=20
style=3D"BORDER-LEFT: #000000 2px solid; MARGIN-LEFT: 5px; =
MARGIN-RIGHT: 0px; PADDING-LEFT: 5px; PADDING-RIGHT: 0px">
<DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
<DIV=20
style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
<A href=3D"mailto:momof2preemies@oceana.net"=20
title=3Dmomof2preemies@oceana.net>Rosann Juska</A> </DIV>
<DIV style=3D"FONT: 10pt arial"><B>To:</B> <A=20
href=3D"mailto:trauma-list@trauma.org"=20
title=3Dtrauma-list@trauma.org>trauma-list@trauma.org</A> </DIV>
<DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Sunday, March 03, 2002 =
5:11=20
PM</DIV>
<DIV style=3D"FONT: 10pt arial"><B>Subject:</B> Re: (no =
subject)</DIV>
<DIV><BR></DIV>
<DIV><FONT color=3D#008080 face=3D"Goudy Old Style">I love the Combi =
tube!!! I=20
often use it instead of an oral or nasal, if the situation is right. =
You can=20
not use it for persons under 5 foot, has a gag reflex, a person who =
had=20
ingested a corrosive substance of someone with an esophageal disease =
such as=20
Cancer, or severe upper airway bleeding b/c it will pass directly =
into the=20
lungs once the cuff has closed off the esophagus. It can be inserted =
"blindly" which avoids improper placement. I am not sure if this =
answered=20
your question, but if not I can try again!</FONT></DIV>
<DIV><BR>=B8..=B7 =B4=A8=A8)) =
-:=A6:-<BR> =B8.=B7=B4=20
.=B7=B4=A8=A8))<BR> ((=B8=B8.=B7=B4 =
..=B7=B4 -:=A6:- <BR> =20
-:=A6:- ((=B8=B8.=B7=B4* =20
=
<BR> &nb=
sp; =20
Rosann Juska</DIV>
=
<DIV> &n=
bsp; =20
EMT-P/ER Tech/IC<BR>"We all take different paths in life, but no=20
matter<BR> where we go, we take a little of each other=20
everywhere."<BR>--- Tim McGraw</DIV>
<DIV> </DIV>
<DIV>"The fate of the wounded rest<BR>in the hands of the one=20
that<BR>applies the first dressing."<BR>-- Nicholas Senn, =
1896<BR></DIV>
<BLOCKQUOTE=20
style=3D"BORDER-LEFT: #008080 2px solid; MARGIN-LEFT: 5px; =
MARGIN-RIGHT: 0px; PADDING-LEFT: 5px; PADDING-RIGHT: 0px">
<DIV style=3D"FONT: 10pt arial">----- Original Message ----- =
</DIV>
<DIV=20
style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
<A href=3D"mailto:kdlamb@prodigy.net" =
title=3Dkdlamb@prodigy.net>Keith D.=20
Lamb</A> </DIV>
<DIV style=3D"FONT: 10pt arial"><B>To:</B> <A=20
href=3D"mailto:trauma-list@trauma.org"=20
title=3Dtrauma-list@trauma.org>trauma-list@trauma.org</A> ; <A=20
href=3D"mailto:RC_WORLD@LISTSERV.IUPUI.EDU"=20
title=3DRC_WORLD@LISTSERV.IUPUI.EDU>Respiratory Care Professionals =
World=20
Forum</A> ; <A href=3D"mailto:ccm-l@list.pitt.edu"=20
title=3Dccm-l@list.pitt.edu>ccm-l@list.pitt.edu</A> </DIV>
<DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Sunday, March 03, =
2002 7:58=20
AM</DIV>
<DIV style=3D"FONT: 10pt arial"><B>Subject:</B> (no subject)</DIV>
<DIV><BR></DIV>
<DIV><FONT face=3DArial size=3D2>How often are folks intubating =
with double=20
lumen endotracheal tubes and for what indications? I don't meant =
intra-op=20
for thoracic surgery...but pre-op...or post-op...for specific=20
injury/pathology and to facilitate independent lung ventilation.=20
</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>For what injury/pathology are you =
seeing this=20
performed most often? Example parenchymal injury/pathology or =
bronchus=20
injury.....fistula etc. </FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>When your patient IS intubated in =
this=20
fashion and each lung is being ventilated independently.....what =
kind of=20
strategy do you employ regarding ventilator modes. Do you =
synchronize or=20
not. Do you attempt to use just a little bit of CPAP with the =
injured=20
side...or some other strategy. Do you conventionally ventilate the =
healthy=20
lung and "jet" or "oscillate" the injured =
lung? Does tracheal=20
gas insufflation have a role in this setting? Any=20
thoughts?</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>keith</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>Keith D. Lamb RCP, =
RRT</FONT></DIV>
<DIV><FONT face=3DArial size=3D2>Charge Respiratory =
Therapist<BR>Christiana=20
Care Hospital<BR>Newark,=20
Delaware</FONT></DIV></BLOCKQUOTE></BLOCKQUOTE></BLOCKQUOTE></BODY></HTML=
>
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