Reader Request: Loop Closure
I received a reader request yesterday to discuss loop closure in trauma PI. To answer this common question, I’m going to do a three day / three part series on this topic.
Tomorrow: what the heck is loop closure, anyway?
Tuesday: loop closure for trauma peer-related issues.
Wednesday: loop closure for system-related issues.
And keep sending requests!
An air leak is a sure-fire reason to keep a chest tube in place. Fortunately, many air leaks are not from the patient’s chest, but from a plumbing problem. Here’s how to locate the leak.
To quickly localize the problem, take a sizable clamp (no mosquito clamps, please) and place it on the chest tube between the patient’s chest and the plastic connector that leads to the collection system. Watch the water seal chamber of the system as you do this. If the leak stops, it is coming from the patient or leaking in from the chest wall.
If the leak persists, clamp the soft Creech tubing between the plastic connector and the collection system itself. If the leak stops now, the connector is loose.
If it is still leaking, then the collection system is bad or has been knocked over.
Here are the remedies for each problem area:
Note: If you are using a “dry seal” system (click here for more on this) you will not be able to tell if you have a leak until you fill the seal chamber with some water.
Fatigue Week
Don’t miss Fatigue Week Part II: Fatigue and Prehospital Providers. This post will go live tomorrow at 10AM Eastern Time (US).
Please feel free to leave comments or requests!
Michael
(Photo credit http://thirdrail.smorgasblog.com/archives/2005_11.html)
What The Heck Is It?
Okay, here’s another one for you to identify. The only clue you get is that the patient was injured 3 days prior to this photo being taken.
Leave your guesses in the comments, and I’ll reveal on Monday.
A New Method For Killing Antibiotic Resistant Bacteria
IBM and the Institute for Bioengineering and Nanotechnology have developed a novel way of wiping out antibiotic resistant bacteria like MRSA. They created a type of nanoparticle that is activated by contact with water. When this occurs, it self-assembles into a new polymer structure that is attracted to infected cells and bacteria, but not healthy cells.
Changes in electrostatic charge on the cell surface attracts the nanoparticles, which then physically break through the cell walls and membranes of bacteria. The nanoparticles then degrade and are excreted.
Bottom line: This is a very exciting line of research. Bacteria multiply and evolve rapidly, sharing genetic information that allows them to change their biochemistry and become resistant to our usual antibiotics. Since the destructive process used by these nanoparticles is purely physical and not biochemical, it will be extremely difficult for any type of resistance to develop. This is an important advance in our efforts to control pathogens.
Reference: Biodegradable nanostructures with selective lysis of microbial membranes. Nature Chemistry, April 3, 2011 (online).