Nurse Nacole ◂ Nursing Resources

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 23 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
A patient's effort affects ventilation distribution. A passive positive-pressure breath without diaphragmatic contraction distributes to more nondependent regions. In contrast, an active diaphragm facilitates gas distribution to more dependent zones.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 22 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
The flow pattern in mechanical ventilation influences distribution. For example, in obstructive inhomogeneities, slow and constant flows tend to distribute gas more evenly (although consequent shorter expiratory times may worsen air trapping).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 21 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Positive-pressure breaths tend to distribute more towards alveolar units with high compliance and low resistance and away from obstructed or stiff units. This creates the potential for overdistention of healthier lung units, even with “normal” volumes.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 20 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
A positive-pressure tidal breath is distributed among the millions of alveolar units in the lung. Factors affecting this include resistances, compliances, functional residual capacities, flow pattern and the presence or absence of patient inspiratory efforts.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 19 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Development of intrinsic PEEP (PEEPi) will have different effects in pressure vs. flow targeted ventilation. In flow targeted ventilation, the constant delivered flow and volume means that a rising PEEPi will increase both the Ppeak and the Pplat.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 18 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
The potential for developing intrinsic (auto) PEEP rises with increases in the minute ventilation, decreases in the expiratory time fraction or increases in the expiratory time constant (i.e., with higher R or Crs values).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 17 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Intrinsic (auto) PEEP depends on three factors: the minute ventilation, the expiratory time fraction and the respiratory system’s expiratory time constant (the product of resistance and compliance).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 16 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Intrinsic (auto) PEEP is the positive end-expiratory pressure that develops within alveoli because of insufficient expiration time, either because of inadequate time between breaths or increased expiratory resistance and collapse (flow limitation).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 15 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
With flow targeting in ventilation, the ventilator regulates the airway pressure to maintain a clinician-determined flow pattern. In contrast, for pressure targeting, the ventilator adjusts flow to maintain a clinician-determined inspiratory pressure.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 14 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
In general, modern ventilator breaths can be initiated (triggered) by patient effort (assisted breaths) or by the machine timer (controlled breaths). Target or limit variables are either a set flow or a set inspiratory pressure.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 13 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
In modern ventilators, tidal breaths are generated by metering this gas flow and can be classified by what starts the breath (trigger variable), what controls gas delivery during the breath (target or limit variable) and what ends the breath (cycle variable).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 12 Aug 2026 12:30:00 +0000

Category: Critical Care Nursing
Older guidelines recommended tracheostomy after 3 weeks of endotracheal intubation if extubation did not occur by 21 days. Now, it is standard practice to perform the procedure after roughly 2 weeks of endotracheal intubation.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 11 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
One common adverse event in the percutaneous tracheostomy postoperative period is accidental cannula displacement. Dislodged tracheal tubes within 7 days of insertion should be replaced with a tube the same size or smaller.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 10 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Early percutaneous tracheostomy procedure-related complications include hemorrhage with bleeding controlled by local pressure or exploration or desaturation because of subcutaneous emphysema with or without pneumothorax.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 10 Aug 2026 00:55:38 +0000

Category: Critical Care Nursing
Percutaneous tracheostomy procedure-related complications include oxygen desaturation and difficult cannula placement due to tracheostomy tube occlusion (from blood clot or mucus plug) or tube insertion into the wrong tract.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 08 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Surgical tracheostomy can be safer when anatomic landmarks are difficult to palpate, the patient presents with a malignancy at the site of insertion, or if emergency tracheostomy placement is required.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 07 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Surgical tracheostomy remains the method of choice in critically ill patients presenting with distorted neck anatomy, prior neck surgery, cervical irradiation, maxillofacial or neck trauma, morbid obesity, difficult airway or coagulopathy.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 06 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Surgical tracheostomy complications include minor or major hemorrhage, tracheo-innominate fistula, subglottic stenosis, oxygen desaturation, subcutaneous emphysema, pneumothorax, accidental decannulation and airway loss.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 05 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Two basic tracheostomy methods are available: Percutaneous tracheostomy and surgical tracheostomy. The choice of whether to use one or the other depends on available resources, operator experience and degree of patient complexity.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 04 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Use of a tracheostomy tube can aid in weaning from mechanical ventilation, because the direct approach to the trachea (with an internal diameter greater than in the translaryngeal approach) and reduced length all reduce airflow resistance.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 03 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Tracheostomy offers many clinical benefits for patients with respiratory failure or individuals requiring prolonged mechanical ventilation or airway protection because of neurologic dysfunction.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 02 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
During general anesthesia or after episodes of acute respiratory failure, patients are usually mechanically ventilated through an orotracheal tube, which can be easily and rapidly inserted as an initial airway device.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 01 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Resource management principles important for an efficient airway management team include explicit role assignments, closed loop communication and standardized guidelines for equipment, medication preparation and positioning.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 31 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Fourth National Audit Project (NAP4) found that preparation, equipment and communication errors were the most common causes of complications during airway management in ICUs and EDs in the United Kingdom.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 30 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Awake intubation provides the opportunity to preserve spontaneous respiration and prolong the time for intubation attempts. Upright fiber-optic–assisted intubation through a Williams or Ovassapian airway is a common and effective approach.