RT Book, Section
A1 Guzzo, Angelina
A1 Johnson, Liane B.
A1 Hung, Orlando R.
A2 Hung, Orlando R.
A2 Murphy, Michael F.
SR Print(0)
ID 1146618072
T1 Performing an Elective Percutaneous Dilational Tracheotomy in a Patient on Mechanical Ventilation
T2 Hung's Difficult and Failed Airway Management, 3e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259640544
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1146618072
RD 2024/04/18
AB A  28-year-old,  previously  healthy  female  was  thrown  off  an  all  terrain  vehicle  (ATV)  and  sustained  blunt  trauma  to  her  chest.  Her  injuries  included  a  flail  chest  with  fractures  of  the  right  first  and  second  ribs,  a  pulmonary  contusion,  as  well  as  a  right  femur  fracture  and  ruptured  spleen.  Following  a  splenectomy  on  the  first  night,  she  stabilized  hemodynamically  and  subsequently  underwent  an  open  reduction  internal  fixation  of  the  fractured  femur.  On  the  10th  day,  she  failed  an  extubation  attempt  due  to  hypoxemia.  Currently  she  is  being  ventilated  with  a  pressure  support  of  12  cm  H2O,  positive  end-expiratory  pressure  (PEEP)  of  5  cm  H2O  and  FiO2  0.50.  Her  ABG  shows  a  pH  7.47,  PCO2  37  mm  Hg,  PO2  60  mm  Hg,  and  HCO3  26  mEq·L−1.  Her  respiratory  rate  is  20  breaths  per  minute.  All  other  vital  signs  are  stable.  You  have  been  consulted  to  help  perform  a  tracheotomy.