tracheostomy

Emily speaks with critical care physician Hannah Wunsch about her book The Autumn Ghost, which tells the story of a polio epidemic in Copenhagen in the 1950s, and how it gave birth to the invention of the modern ventilator and the field of ICU medicine.

Find show notes, transcript, and more at thenocturnists.com.

 

In this episode, we will hear from Addie Begley,a neonatal nurse practitioner at Children's Mercy. She will be leading a discussion focusing on the Infant Tracheostomy and Home Ventilator Program, and the services the clinic offers for its patients.

For this podcast, I continued my conversation with Jessica Wolff. We discussed what their life was like once they brought Lily home. She explains how they adjusted to caring for Lily with her tracheostomy along with the necessary life-saving equipment and how all of that completely changed once COVID hit. 

We discussed how the plan for Lily’s decannulation went completely sideways, how they coped with it, and how they learned that Lily actually needed a full laryngotracheal reconstructive surgery. Jessica proudly shares how Lily is doing today, medically, developmentally and emotionally and how they are navigating everything as a family, especially in preparation for sweet Lily to head to Preschool!

We conclude the episode speaking about Nolan, Jessica and Pat's son who they welcomed earlier this year who also spent some time in the NICU. 

Jessica shares some great information and advice pertinent to other families who are either currently in the NICU and weighing the heavy decision of a tracheostomy for their child, or for the families who have a child at home with a tracheostomy, as well as families who have suffered or may suffer a loss. Listeners will be surprised to hear some of the unexpected emotions that Lily and the Wolff family has had to work through once Lily had her trach removed. And again, you will be amazed by how strong and resilient Lily and the entire Wolff family is! I hope you enjoy the episode! 


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For our most recent podcast episode, I sat down with Jessica Wolff, a mother who has endured loss and 2 very different NICU journeys. For part one of this podcast, she shares personal details on her very complicated twin pregnancy and the difficult choices they had to make along the way. She reflects back on regrets both she and her husband, Pat have experienced as well as what helped them cope through their daughter, Lily’s 256-day NICU stay.

Jessica explains what helped them make the decision whether or not Lily should have a tracheostomy placed and she speaks candidly about what their expectations were after Lily’s tracheostomy placement, versus their reality. She offers frank advice for NICU families, especially those with similar situations who have children with feeding issues, ostomies, bronchopulmonary dysplasia or BPD, pain medication withdrawal, tracheostomies, and what going home looked like for their family with a ventilator-dependent child. 

You will be amazed by what this family has been through, but even more so by their strength and resiliency. Sweet Lily has touched so many lives in her short 4 years, and this is just the beginning of her story, I know she’ll pull on your heart strings as well. So sit back and listen to part one of this family’s story with Jessica Wolff. 


Our NICU Roadmap: A Comprehensive NICU Journal: https://empoweringnicuparents.com/nicujournal/

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Infants in the NICU are patients that require specialized care with unique clinical considerations. Specific recommendations must be considered for all systems of NICU patients and the skin is not any different. Infants who are being cared for in the NICU, especially those that were born premature have an increased risk for skin trauma. On this episode, we review some of the skin care guidelines and recommendations available for clinical practice of NICU patients.

As NICU clinicians, is is important to not only be aware of the anatomical variations of a term and preterm infant’s skin, but to also know how that guides their clinical care and treatment plan. Many of the topics we cover on this episode have been standards of care for years, but there are also new recommendations for practice and products available based on recent research findings. 

NICU clinicians will hear a great review as well as up-to-date clinical recommendations for skin care of our specialized population in the NICU. The episode will also be beneficial for parents to hear the clinical practice guidelines and recommendations for term and preterm infants as well as some of the variations that may exist between different institutions.

Our NICU Roadmap: A Comprehensive NICU Journal: https://empoweringnicuparents.com/nicujournal/

NeoTech Products: https://www.neotechproducts.com/

Solly Baby: http://shrsl.com/2py8h

NICU Mama Hats: https://empoweringnicuparents.com/hats/

NICU Milestone Cards: https://empoweringnicuparents.com/nicuproducts/

Empowering NICU Parents Show Notes: https://empoweringnicuparents.com/episode36

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James Day and Olusegun Olusanya interview Duncan Young, Director of Research for the UK Intensive Care Society about his work in the TracMan Trial. Young discusses the results of the trial as well as challenges with clinical trials and directions for future research. He also gives a few tips for young doctors looking to get involved with research.

The recently published paper in JAMA on the TracMan trial is found here.

JICS is the Journal of the Intensive Care Society and is in the process of becoming indexed on Medline.

Keaton Jones, Academic trainee at University of Nottingham and Royal Derby Hospital, UK, introduces stomas. In this video podcast stoma is defined, types of stoma discussed (especially ileostomy and colostomy, loop and end stomas) and complications listed. Keaton also takes you through how to examine a patient with a stoma (these patients tend to crop up in exams!)
This video podcast will be useful for medical students as learning and interns and junior residents (foundation and core trainees) as revision for exams

Although tracheostomy is one of the oldest and most common surgical procedures, management is often based on opinion and local practices because of a paucity of high level evidence to guide care.  To address this issue, the AAO-HNS convened a national expert panel representing pediatric and adult otolaryngology, laryngology, head and neck oncologic surgery, advanced nursing practice, respiratory therapy, and emergency medicine.  Using systematic review and a modified Delphi method the group achieved consensus on 77 statements that address emergencies, complications, decannulation, perioperative care, ancillary devices, and patient education.  Part one of this podcast emphasizes supportive care and patient education from the perspective of two nurses on the expert panel.  Part two offers the physician perspective from two panel participants with expertise in adult and pediatric tracheotomy care.  A common theme is the importance of engaging patients and caregivers in all aspects of decision making and supportive care to improve outcomes and reduce complications.

Although tracheostomy is one of the oldest and most common surgical procedures, management is often based on opinion and local practices because of a paucity of high level evidence to guide care.  To address this issue, the AAO-HNS convened a national expert panel representing pediatric and adult otolaryngology, laryngology, head and neck oncologic surgery, advanced nursing practice, respiratory therapy, and emergency medicine.  Using systematic review and a modified Delphi method the group achieved consensus on 77 statements that address emergencies, complications, decannulation, perioperative care, ancillary devices, and patient education.  Part one of this podcast emphasizes supportive care and patient education from the perspective of two nurses on the expert panel.  Part two offers the physician perspective from two panel participants with expertise in adult and pediatric tracheotomy care.  A common theme is the importance of engaging patients and caregivers in all aspects of decision making and supportive care to improve outcomes and reduce complications.