- Getting frustrated with the sluggish travel of the R.B.C.s in the transfusion set? You can try this method....
- Choose the i.v access through which you are going to infuse the PRBC
- Attach a 100/150 cm venous extension line with a 3-way stop cock to this line after de-airing it
- To one of the ports of the 3-way, attach a 500 ml [0.9%] Normal Saline with an iv drip set and to the other port, attach the PRBC pack with the blood transfusion set
- Hang the NS bottle on a drip stand and place the PRBC pack well below, on a table
- Adjust the 3-way in such a way that the NS [hanged on the drip stand] flows through the 3-way and into the PRBC pack
- Allow to fill the PRBC pack with NS till the pack is fully distended
- Now close both the NS and PRBC drip sets
- Hang the PRBC pack on the drip stand--> open the 3-way in such a way that the PRBC flows into the patient--> And open the PRBC transfusion set
- Complete the transfusion within the recommended time as per the institution policies.
Plan and strategies in the ventilatory management changes according to the situation
anaesthetist should start keeping an eye on the patient @ the point of admission to ICU itself [if possible] and well before he/she goes into a respiratory CRISIS
meanwhile patient may respond to iv anticholineesterases / plasmapheresis and may escape a respiratory failure
Some patient may tide over the crisis with BiPAP / NIV
serial ABGs may be needed
PaO2 less than 60 and PaCO2 more than 50 is a sign board towards need for invasive ventilation
with all the above modalities of Rx, healthy recovery and discharge from the ICU is a common scene now...
SOME KEY POINTS: They are prone for atelectasis due to poor cough, low tidal volume breaths and this adds to the total work of breathing and also produces hypoxia
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