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Preparing to assist with yet another bedside percutaneous tracheotomy. We seem to do a million of these in our ICU. Someone sits on a vent for more than 10-15 days, talk of a trach immediately comes up as a way to wean the patient off the ventilator that much quicker. And there is some value to that thinking. The patient is only having to breath through about 6 centimeters of tubing instead of 22-30cm. Their mouth is free to have regular oral care. No more painful straps on their face. It gives their lungs a chance to recover from the increased work of breathing that ventilation via an endotracheal tube causes. Perhaps most importantly, the longer a patient is on ventilator, the greater their risk of developing ventilator-acquired pneumonia (VAP). I think the figure is something like 3% greater risk each day on the vent.
Anyhow, turning a regular ICU pod into a mini-surgical suite isn't a terribly big deal in unit. It was designed to function that way. It just seems as if theres a million drugs to acquire, pieces to set aside, given residents never seem to get anything for themselves. The nurse has to get it all. And then you're expected to stand there and push the drugs while the residents all stand around watching the MD actually doing the procedure. I could do with a little less standing around and a little more learning by doing. ;)
