Critical Care Practice Guidelines


Airway Diseases

SOURCE: The Global Initiative for Chronic Obstructive Lung Disease

Recognition of signs of an impending or actual airway emergency. Initial treatment and continued management of airway emergencies to minimize the likelihood of adverse outcomes, in adults, children, and infants.
SOURCE: American Association for Respiratory Care Clinical Practice Guidelines, 1995

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Cough

Directed cough (DC) to clear or mobilize secretions is a component of bronchial hygiene therapy when spontaneous cough is inadequate. Directed Cough is a deliberate maneuver that is taught, supervised, and monitored. Forced expiratory technique (FET, or huff cough) and manually assisted cough are examples of directed cough.
SOURCE: American Association for Respiratory Care Clinical Practice Guidelines, 1993

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Mechanical Ventilation

Although the number of chronic VAIs in acute care hospitals is small relative to the total number of patients receiving mechanical ventilation, VAIs consume a disproportionate share of health-care expenditures and occupy ICU beds for prolonged periods. VAIs, therefore, pose a unique set of questions for the health-care team.
SOURCE: American College of Chest Physicians Consensus Statement, 1998

The application of time-triggered, pressure-limited, time-cycled mechanical ventilation in the neonate is typically accomplished by the use of commercially available pressure-limited ventilators specifically designed for this population or of multipurpose, multimodal ventilators with the necessary capabilities. These ventilators permit precise management of ventilator settings.
SOURCE: American Association for Respiratory Care Clinical Practice Guidelines, 1994

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Neonatal and Pediatric Patients

The selection of an oxygen delivery system for neonatal and pediatric patients includes patients with and without artificial airways.
SOURCE: American Association for Respiratory Care Clinical Practice Guidelines, 1996

Capillary blood gas (CBG) samples may be used in place of samples from arterial punctures or indwelling arterial catheters to estimate acid-base balance (pH) and adequacy of ventilation (PaCO2). Capillary PO2 measurements are of little value in estimating arterial oxygenation.
SOURCE: American Association for Respiratory Care Clinical Practice Guidelines, 1994

Transcutaneous monitoring of oxygen (PtcO2) and carbon dioxide (PtcCO2) in neonates, infants, and small children -- this guideline does not address the application of transcutaneous monitoring in adults and older children.
SOURCE: American Association for Respiratory Care Clinical Practice Guidelines, 1994

The application of continuous positive airway pressure to neonates and infants by nasal prongs (NCPAP) or by nasopharyngeal tube (NP-CPAP) used in conjunction with a commercially available continuous-flow infant ventilator or a suitably equipped multipurpose ventilator.
SOURCE: American Association for Respiratory Care Clinical Practice Guidelines, 1994

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Nutrition

Nutrition support is a routine part of ICU therapy. It is recommended to treat and prevent malnutrition and nutrient deficiencies and generally benefits patient outcomes, although adverse effects and complications of the therapy do occur. Because a large number of clinical studies of applied nutrition have been performed in ICU patients, a consensus panel was commissioned to summarize current knowledge and formulate recommendations.
SOURCE: American College of Chest Physicians Consensus Statement, 1997

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Thromboembolic Disease

The purpose of this consensus report was to address clinically relevant questions related to the diagnosis and management of acute pulmonary embolism and deep venous thrombosis.
SOURCE: American College of Chest Physicians Consensus Statement, 1998

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