Upper respiratory Infections

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Upper respiratory Infections

• Upper respiratory tract infections cause ,
  incidence, clinical manifestations, management
  and prevention

• Management of a patients with epitasis

• Management of a patient with upper airway
  obstruction

• Tracheostomy Care

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What is Influenza?

Health Canada 1998
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Incidence

• 500 to 1,500 Canadians die from influenza or its
  complications every season

• Influenza vaccine may reduce hospital admission
  for pneumonia, influenza, bronchitis emphysema
  by 70 and mortality by 85 ( Health Canada 2001)

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Recommended for

• Adults children with chronic heart /Lung
  disease

• Persons resident in nursing homes / chronic care
  facilities

• Persons over 65 years

• Persons with chronic conditions diabetes, immuno
  suppression, kidney disease

• Persons with HIV

• Children and adolescents on long tern
  acetylsalicylic acid

• People who are capable of transmitting influenza
  ( Health care workers household contacts)

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Nevertheless only 70 of long term care facility
residents and 20 to 40 of adults children
with medical conditions listed previously receive
the vaccine annually ( Duclos et all1996, DeWals
et al (1996) Health Care workers in hospitals and
long term care facilities have shown vaccination
rates of 21 to 61 (Adal 1996, Nickol (1997)
Fowles (1998)
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Demystifying Myths

• Vaccination is 70 to 90 efficient

• The vaccine does not cause flu

• occasional soreness at injection site may occur
  may occur

• Side effects are rare but may consist of fever,
  aching muscle /joints lasting for one/two days
  and beginning six to 12 hours after immunization

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Demystifying Myths

• Vaccination is considered safe for pregnant women
  and does not adversely affect breast feeding
  mothers and their infants

• Influenza vaccine should not be given to people
  who had an anaphylactic reaction to previous does
  or who are allergic to eggs

• Individuals with acute febrile illness should not
  be vaccinated until their symptoms have abated

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Indications for Tracheotomy

• Relief of acute / chronic upper airway obstruction

• To assist in aspiration of bronchial secretions

• To aid prolonged ventilation

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Tracheostomy
A surgical opening through the skin of the neck
into the trachea
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Tube Characteristics
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Anatomical Position of tube
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Pre operation

• If client is to undergo elective tracheostomy,
  reinforce education

• A visit by a patient with a permanent
  tracheostomy may be desirable

• In emergency situations patient education needs
  to be brief or may have to be postponed/given to
  significant others

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Post Operative Care

• Ineffective airway clearance /gaseous exchange

• Risk for infection

• Risk for aspiration

• Risk for constipation

• Impaired verbal communication

• Fear and anxiety

• Altered body image

• Ineffective management of therapeutic regime

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Complications of tracheostomy

• displaced tubes

• Blocked tubes

• Surgical emphysema

• Wound and respiratory tract infections

• hemorrhage

• Tracheal stenosis

• Tracheoesophageal fistula

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