Use of Medical Lasers for Airway Disease
Laser Wavelength (nm) Delivery device Scope Depth of penetration Uses Coagulation Cutting Nd:YAG 1,060 Quartz fiber RB/FB 0.5–1.5 cm +++ + CO2 10,600 Coupler and waveguide RB 0.23 mm +…
Approach to Unclear Exudates
Light’s criteria Value Pleural fluid to serum protein ratio >0.5 Pleural fluid to serum LDH ratio >0.6 Pleural fluid LDH concentration >2/3 upper limit of lab normal value Table 65.2…
Advanced Medical Thoracoscopy-Pleuroscopy Procedures
Fig. 61.1 Bulla of the apex in white light (a) and after inhalation of fluorescein (b) (Courtesy of Prof. Marc Noppen) Another technique applied recently to investigate bullous or emphysematous…
Cricothyroidotomy
Fig. 67.1 Anterior neck landmarks for cricothyroidotomy (From Montgomery W. Surgery of the Larynx, Trachea and Esophagus. Philadelphia: Elsevier; 2002, p. 261. Reprinted with permission from Elsevier) The CT membrane…
Management of Massive Hemoptysis
Infection Tuberculosis/mycobacterial infection Bronchiectasis Fungal infections (primary or mycetoma) Lung abscess Paragonimiasis Hydatid cyst Necrotizing pneumonia Septic emboli Neoplasm Lung cancer (non-small or small cell) Pulmonary carcinoid Endobronchial metastases Parenchymal…
Quality Control Mechanism for Endoscopic Procedures
Fig. 5.1 Typical quality control steps Fig. 5.2 Typical quality assurance steps Methods of Quality Improvement Developing a quality monitoring process requires the use of an established system. This system…
Brachytherapy
Score Hemoptysis 0 None 1 Less than twice per week 2 Less than once daily but greater than twice per week 3 Daily, bright red blood or clot 4 Decrease…
Thoracentesis
Volume of pleural fluid Physical examination findings <250–300 cm3 Probable normal examination 500 cm3 1. Dullness to percussion 2. Decreased fremitus 3. Normal vesicular breath sounds but decreased intensity 1,000…
Chest Tube Placement
•Pneumothorax °Tension pneumothorax (idiopathic, traumatic pneumothorax with valve mechanism, etc.) °Pneumothorax on mechanical ventilation °Persistent or recurrent iatrogenic pneumothorax after needle aspiration °Symptomatic pneumothorax °Large pneumothorax •Malignant pleural effusion •Empyema…
Microdement
Fig. 34.1 Serrated microdebrider blade Fig. 34.2 Handpiece with suction tubing attached Fig. 34.3 Console and foot pedal History of the Microdebrider Dr. Jack Urban is credited with the development…
