Never seen a city as colorful as Chefchauoen, Morocco, the blue city with alleyway upon alleyway painted various shades! So worth a trek to get out there with @acanelaexpeditions. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
For those of you asking about the watch I posted on my story, it’s from @arvo, I’m wearing it in this photo, too! Even in the most colorful city, gotta stick with my usual color palette, black on black, for my watch.
📸 @mitchellthayne #AcanelaMorocco#Morocco
Ser mimada é bom demais né não?
Na nossa última #plastictrip fomos tão bem recebidas em tantos lugares. E em dois deles : Galeria @melissaoficial e @clubemelissapatiohigienopolis , além das Melissas lindas que vocês já viram passeando pelo feed, ainda ganhamos esse tanto de item exclusivo, de colecionadora, e super desejooooo da vida!
Só temos a agradecer ❤️
Ventilators are often a source of anxiety and stress for new graduates or those new to critical care, ER or ICU, but in fact once you understand how they work, the modes and how easy they actually are to troubleshoot you'll learn to love your vented patients. 💉
First off, remember that as long as you have a BVM within reach, IT IS NO BIG DEAL if your ventilator tubing connection (called a circuit) is lost. Just like you can hold your breath for a few seconds, so can a patient and although it isn't ideal, they aren't going to die if they miss a few respirations. In fact in many hospitals, patients on ventilators are transferred from ER to ICU via BVM and then placed back on the vent since pushing a large circuit around is nothing short of cumbersome. 💊
If the connection is lost...stay calm, and either reconnect the circuit, or grab your BVM, attach, and squeeze every 5 seconds until you can correct the problem...or RT saves your butt. 💉
The second source of anxiety are the alarms a vent produces. There are many but most can be categorized into two types, high and low pressure alarms. 💊
It is important to know the causes of these alarms so you can troubleshoot the problem and fix the vent or yout patient. 💉
High pressure alarms arise from the vent struggling to overcome some resistance and thus inhibit adequate oxygen delivery to the patient. Common causes include (in order of most common to not): patient coughing, a kink in the circuit, a gunky patient patient (suction!!), stepping on the circuit, patient biting the ET tube, increased airway resistance, & reduced lung compliance (ARDS & Pneumothorax)! 💊
Low pressure alarms indicate there is little to no resistance in within the circuit, which should be physiologically impossible in the case of a fully sealed set-up and chest cavity. Common causes include: patient disconnected from the ventilator (commonly at the site of the tube), leaky circuit, airway leaks (check balloon inflation!), chest tube leaks or dislodgement, and hypovolemia.
A good mnemonic for identifying vent alarm causes that I learned when starting critical care was D.O.P.E (Dislodgement, Obstruction, Pneumothorax, Equipment)!
[PT-EN] A primeira vez que comi a sanduíche de pastrami da @zdelisandwiches foi há uns bons anos, quando o projeto não passava de um ‘vão de escada’ nos Jardins. De lá para cá, cresceu e multiplicou-se em vários endereços (este fica no Centro); mas o pastrami continua de comer e chorar por mais | Best pastrami sandwich in town #zdelisanduiches#addressbookbyjms_sp