Evidence Based Practice:  Estimation of endotracheal tube cu…

Evidence Based Practice:  Estimation of endotracheal tube cuff pressure utilizing subjective techniques are consistently inaccurate as compared to objective techniques.  Estimation techniques include minimal leak, minimal occlusion, estimation of air for inflation, and palpation of the pilot balloon.  The use of a manometer is an objective technique and should be used to directly assess ETT cuff pressure. Direct assessment of ETT cuff pressure reduces the risk of ischemic tracheal injury. (Stewart, 2003)    Subsequent studies support the findings by Stewart, et. al.     Based on the evidence, the most effective way to avoid tracheal ischemia due to high endotracheal tube (ETT) cuff pressures is?

An adult patient refuses a regional block for an examination…

An adult patient refuses a regional block for an examination under anesthesia and exploration of a complex laceration to the left lower leg.  Following induction, the surgeon examines the laceration and states, “this is a deep wound.  The bone is involved.  This is going to require a lot of work and it’s going to be painful post-op.  Please put a block in her before she wakes up.”  With this new information you decide to place a regional block to minimize post-operative opioid use.  Which of the following is correct?