ABSTRACT
In neuromuscular disorders (NMDs), nocturnal non-invasive ventilation (NIV) via a nasal mask is offered when hypercapnic respiratory failure occurs. With disease progression, nocturnal NIV needs to be extended into the daytime. Mouthpiece ventilation (MPV) is an option for daytime NIV. MPV represents a difficult task for home ventilators due to rapidly changing load conditions resulting from intermittent connections and disconnections from MPV circuit. The 252nd ENMC International Expert Workshop, held March 6th to 8th 2020 in Amsterdam, reported general guidelines for management of daytime MPV in NMDs. This report could not present all the detail regarding the technical issues important for clinical success of MPV. Based on the expert workshop discussions and the evidence from existing studies, the current narrative review aims to identify the technical issues of MPV and offers guidance via a decisional algorithm and educational figures providing relevant information that is important for successful implementation of MPV.
Subject(s)
Neuromuscular Diseases/complications , Noninvasive Ventilation/methods , Respiratory Insufficiency/prevention & control , Education , Humans , Patient Education as Topic , Practice Guidelines as Topic , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapyABSTRACT
Stickler syndrome is one of the most common clinical syndromes in Europe although it is also one of the least known and consequently most misidentified. Because Stickler syndrome affects connective tissue, many different symptoms present, from vision to mobility difficulties. This article examines the main symptoms of the syndrome and includes an insightful personal account showing how it affects the whole family.
Subject(s)
Arthritis/nursing , Cleft Palate/nursing , Connective Tissue Diseases/nursing , Deafness/nursing , Education, Nursing, Continuing , Myopia/nursing , Nursing Diagnosis , Arthritis/diagnosis , Arthritis/genetics , Chromosome Aberrations , Cleft Palate/diagnosis , Cleft Palate/genetics , Connective Tissue Diseases/diagnosis , Connective Tissue Diseases/genetics , Deafness/diagnosis , Deafness/genetics , Diagnosis, Differential , Genes, Dominant , Humans , Myopia/diagnosis , Myopia/genetics , SyndromeABSTRACT
OBJECTIVE: Immediate rescue breathing, or cardiopulmonary resuscitation, may be necessary for the cervical spine-injured football player without removal of the helmet. The purpose of our study was to compare 2 pocket-mask insertion techniques with a face-mask rotation technique to determine which allowed the quickest initiation of rescue breathing with the least cervical spine motion. DESIGN AND SETTING: In a biomechanics laboratory, 3 airway-preparation techniques were tested: chin-insertion technique (pocket mask inserted between the chin and face mask), eye-hole-insertion technique (pocket mask inserted through the face mask eye hole), and screwdriver technique (side loop straps removed using manual screwdriver followed by mask rotation). SUBJECTS: One athletic trainer team and 12 National Collegiate Athletic Association Division III football players. MEASUREMENTS: Time to initiate rescue breathing and induced helmet motion. RESULTS: Both pocket-mask techniques allowed quicker initiation of rescue breathing. Cervical spine anterior-posterior displacement was greater for the chin technique than for the screwdriver or eye-hole techniques. Lateral translation was greater for the screwdriver technique than for either pocket-mask technique. Peak displacement from initial cervical spine position was greater for the chin technique than for the eye-hole technique. CONCLUSIONS: Both pocket-mask techniques allowed quicker initiation of rescue breathing than did rotation of the face mask via loop strap screw removal. The eye-hole insertion technique was faster and produced less cervical spine motion than the other 2 techniques. Each technique produced significantly smaller amounts of cervical spine displacement than that caused by cutting face-mask loop straps as reported earlier. We suggest a protocol for field management of cervical spine injuries in football players.
