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Tod - Special Healthcare Needs

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by

Tod Levesh

on 13 December 2017

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Transcript of Tod - Special Healthcare Needs


Nasoduodenal
Nasojejunal
Gastrostomy
Jejunostomy
Percutaneous endoscopic gastrostomy (PEG)
Percutaneous endoscopic jejunostomy (PEJ)
Public Domain, Wellcome Library; Daniel_Lambert.jpg
Anna Frodesiak (Own work), Public Domain, CC BY-SA 1.0 (Universal Use), producer asserts patient consented to picture, https://commons.wikimedia.org/wiki/File:Patient_receiving_dialysis_03.jpg
Gilo1969 (own work); CC BY-SA 3.0; https://commons.wikimedia.org/wiki/File:PEG_tube_kit.jpg
By Cancer Research UK (own work); OTRS; https://commons.wikimedia.org/wiki/File:Diagram_showing_a_brain_shunt_CRUK_052.svg
By Intellec7 (own work); CC BY-SA 4.0; Post-operative_Jackson-Pratt_Drains.JPG
Long Term Access
Dialysis Complications
By Scott Parish (own work), CC BY-SA 4.0; https://commons.wikimedia.org/wiki/File:Head_neck_tracheostomy.jpg
By Brian Hall (own work); Public Domain; https://commons.wikimedia.org/wiki/File:VIP_Bird2.jpg
Common devices include:
Peripherally inserted central catheter (PICC)
Midline catheter
Double or triple lumen central catheter
Hickman, Broviac, and Groshong catheters
Implanted ports
By General Ludd (own work) CC BY-SA 3.0; https://commons.wikimedia.org/wiki/File:Hickman_line_catheter_with_2_lumens.jpg
By Jsohn (own work), Public Domain; https://commons.wikimedia.org/wiki/File:Triple-Lumen.jpg
Cancer Patient
Receiving Chemo
High Dose Steroids
BGL: 23 mg/dL
"Dialysis - arm - 01" by Anna Frodesiak - Own work. Licensed under CC0 via Commons - https://commons.wikimedia.org/wiki/File:Dialysis_-_arm_-_01.jpg#/media/File:Dialysis_-_arm_-_01.jpg
"Hemodialysismachine". Licensed under CC BY-SA 3.0 via Commons - https://commons.wikimedia.org/wiki/File:Hemodialysismachine.jpg#/media/File:Hemodialysismachine.jpg
"Hemodialysis-en" by GYassineMrabetTalk✉This vector image was created with Inkscape. - Own work from Image:Hemodialysis schematic.gif.. Licensed under CC BY 3.0 via Wikimedia Commons - https://commons.wikimedia.org/wiki/File:Hemodialysis-en.svg#/media/File:Hemodialysis-en.svg
"Peritoneal dialysis" by National Kidney and Urologic Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, USA - http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/images/dialys.gif. Licensed under Public Domain via Commons - https://commons.wikimedia.org/wiki/File:Peritoneal_dialysis.gif#/media/File:Peritoneal_dialysis.gif
"Blausen 0049 ArteriovenousFistula" by BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff. "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. - Own work. Licensed under CC BY 3.0 via Commons - https://commons.wikimedia.org/wiki/File:Blausen_0049_ArteriovenousFistula.png#/media/File:Blausen_0049_ArteriovenousFistula.png
"Radiocephalic fistula" by Kbik at en.wikipedia. Licensed under CC BY-SA 3.0 via Commons - https://commons.wikimedia.org/wiki/File:Radiocephalic_fistula.svg#/media/File:Radiocephalic_fistula.svg
"Blausen 0050 ArteriovenousGraft" by BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff. "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. - Own work. Licensed under CC BY 3.0 via Commons - https://commons.wikimedia.org/wiki/File:Blausen_0050_ArteriovenousGraft.png#/media/File:Blausen_0050_ArteriovenousGraft.png
Types of Dialysis
By Cancer Research UK; CC BY-SA 4.0; https://commons.wikimedia.org/wiki/File:Diagram_showing_the_position_of_a_percutaneous_endoscopic_gastrostomy_(PEG)_feeding_tube_CRUK_341.svg
By Pflegewiki-User HoRaMi, CC BY-SA 3.0; https://commons.wikimedia.org/wiki/File:PEG_01.jpg
Ventricular Shunt
BySyed Ikhwan (own work), CC BY-SA 2.0; https://en.wikipedia.org/wiki/Hydrocephalus#/media/File:Khidmat_Masy_Hydrocephalus_(19042957419).jpg
By CDC; Public Domain; http://www.nj.gov/health/fhs/sch/documents/facts_ccns.pdf
By BlausenGallery 2014 (own work); CC BY-SA 3.0; Blausen 0247 Colostomy.png
DCwom (own work) released into Public Domain by owner; https://commons.wikimedia.org/wiki/File:OstomyPouch.jpg
By Cancer Research UK (own work); CC BY-SA 4.0; https://commons.wikimedia.org/wiki/File:Diagram_showing_a_colostomy_with_a_bag_CRUK_061.svg#/media/File:Diagram_showing_a_colostomy_with_a_bag_CRUK_061.svg
By BruceBlaus (own work); CC BY-SA 3.0; Male Suprapubic Catheter.png
By James Heilman, MD (own work); CC BY-SA 4.0; NewlyPlaceSubprapubic.jpg
By Pollo (own work); CC BY-SA 4.0; Urinary catheterization with a doll.jpg
Special Healthcare Needs
More than 1/3 of American adults are obese
Obese: BMI > 30 kg/m2
Morbidly obese: BMI 40 - 49.9 kg/m2
Extreme obesity: BMI > 50 kg/m2
Airway / Ventilation
Public Domain; Produced for NHLI for U.S. Gov't
Med Admin / Dosing
By Frederik Beuk (own work), CC BY-SA 3.0; Obesitas in Nederland onder
By Sire (own work); CC BY-SA4.0; authorized for reproduction; https://voat.co/v/fatpeoplehate/1338216
Operational Concerns
Long Term Airways & Vents
Suction?
DOPE?
7 y/o URI and Respiratory Distress
By Klaus D. Peter, Wiehl, Germany (Own work) [CC BY 2.0 de (http://creativecommons.org/licenses/by/2.0/de/deed.en)], via Wikimedia Commons
Tubes:
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