Anaesthesia
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To reduce the risk of tracheostomy tube blockage, a removable inner tube can be used. However, this will reduce the size of the lumen and will increase airflow resistance and work of breathing. The magnitude of this increase in workload is unknown. ⋯ The extra work of breathing imposed easily exceeded the normal total work of breathing. Our results will aid a risk-benefit analysis when deciding whether to use inner tubes. Selecting a larger tracheostomy tube is likely to aid weaning from mechanical ventilation.
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Practice Guideline
Immediate post-anaesthesia recovery 2013: Association of Anaesthetists of Great Britain and Ireland.
1. After general, epidural or spinal anaesthesia, all patients should be recovered in a specially designated area (henceforth 'post-anaesthesia care unit', PACU) that complies with the standards and recommendations described in this document. 2. The anaesthetist must formally hand over the care of a patient to an appropriately trained and registered PACU practitioner. 3. ⋯ When critically ill patients are managed in a PACU because of bed shortages, the primary responsibility for the patient lies with the hospital's critical care team. The standard of nursing and medical care should be equal to that in the hospital's critical care units. Audit and critical incident reporting systems should be in place in all PACUs.