Before the procedure Indications Requirement of a temporary or long-term artificial airway for prolonged mechanical ventilation Management of secretions Nonemergency airway obstruction Contraindications Inability to clearly palpate and identify tracheal landmarks Enlarged thyroid or other neck mass Active infection at…
Before the procedure Indications Diagnosis of pneumonia Viral, bacterial, fungal, pneumonias Quantitative cultures for ventilator-associated pneumonias Infiltrates in an immunocompromised host Evaluation of diffuse lung infiltrates and evaluation of interstitial lung disease Suspected pulmonary hemorrhage Suspected malignancies Both bronchoalveolar lavage…
Specialty and category within specialty Intensive care medicine: Diseases of the respiratory system Airway management CPT codes Bronchoscopy ICD-9 codes 33.2 Diagnostic procedures on lung and bronchus 33.22 Fiber-optic bronchoscopy 33.24 Closed [endoscopic] biopsy of bronchus 33.27 Closed endoscopic biopsy…
Before the procedure Indications Most commonly undertaken to treat one of the following conditions: Pneumothorax Pleural fluid collection Hemothorax Simple effusion Empyema Can be both a diagnostic and a therapeutic maneuver Contraindications In an emergent situation (i.e., tension pneumothorax), there…
Before the procedure Indications Pleural effusion is not explained by the clinical presentation Massive pleural effusion with impending respiratory failure Suspected pleural space infection Suspected complication of pneumonia (empyema) Suspected hemothorax Contraindications Absolute Lack of expertise Severe uncorrectable coagulopathy (platelet…
Paracentesis: Before the procedure Indications Paracentesis is the insertion of a needle or catheter into the peritoneal cavity for the purpose of aspirating peritoneal fluid. It is most often indicated for diagnostic or therapeutic evacuation of ascites. Diagnostic indications New-onset…
Preprocedure Indications Pericardial tamponade Pericardiocentesis is the first treatment option in patients with overt tamponade because only the removal of fluid allows normal ventricular filling and restores adequate cardiac output. If the patient is hemodynamically stable, the procedure should be…
Before the procedure Indications Postcardiotomy failure (left ventricular assist device [LVAD]) Elevated left atrial pressure (LAP) and cardiogenic shock despite inotropic support and intraaortic balloon pump (IABP) LAP >25 mm Hg Cardiac index (CI) <2 L/min/m 2 Severe left ventricular…
Before the procedure Indications Treatment of symptomatic bradycardia Sinus bradycardia Second-degree or third-degree atrioventricular block Prophylaxis Bradycardia-induced ventricular tachyarrhythmias (e.g., torsades de pointes) Increased risk of advanced atrioventricular block (e.g., acute myocardial infarction, infective endocarditis, surgery in patients with underlying…
Before the procedure Indications Emergency re-establishment of an organized electrical rhythm Hemodynamically unstable polymorphic ventricular tachycardia Ventricular fibrillation Pulseless ventricular tachycardia Narrow or wide QRS complex tachycardia (ventricular rate >150) associated with hemodynamic instability, chest pain, or pulmonary edema Elective…