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Heimlich Valve (heimlich + valve)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Outpatient Management of Primary Spontaneous Pneumothorax in the Emergency Department of a Community Hospital Using a Small-bore Catheter and a Heimlich Valve

ACADEMIC EMERGENCY MEDICINE, Issue 6 2009
Behzad Hassani
Abstract Objectives:, The objective was to assess the effectiveness of a small-bore catheter (8F) connected to a one-way Heimlich valve in the emergency department (ED)-based outpatient management of primary spontaneous pneumothorax (PSP). Methods:, The authors conducted a structured chart audit in a retrospective case series of patients with PSP who were treated with a small-bore (8F) catheter and a Heimlich valve who were seen in the ED of a community hospital between April 2000 and March 2005. To be eligible, patients had to be available for a telephone interview. Main outcomes were success of treatment (sustained, complete lung reexpansion), admission, and surgical intervention rates. Secondary outcomes included number of chest x-rays (CXRs), number of visits to the ED, treatment duration, complications, and recurrence rates. Results:, The authors identified 62 discrete episodes of PSP in 50 patients, with a mean (±standard deviation [SD]) age of 25.5 ± 10.5 years (range = 14,53 years). In 50 of 62 episodes (81%, 95% confidence interval [CI] = 70.8% to 90.5%), patients were discharged directly from the ED. Patients were admitted to the hospital at some point for treatment in 27/62 episodes (43.5%, 95% CI = 31.2% to 55.9%). Surgery was performed for acute treatment failure in 17 episodes. Ultimately, 19 patients, who accounted for 21 of 62 episodes (33.9%, 95% CI = 22.1% to 45.6%), had surgery at some point in the study. Mean (±SD) time to admission for those patients initially discharged from the ED was 2.9 (±2.01) days (95% CI = 1.9 to 3.8 days). There were no serious complications from treatment; the minor complication rate (misplacement or dislodging of the chest tube) was 22.6% (95% CI = 12.2% to 33.0%). No association was found between the size of pneumothorax and treatment failure. Conclusions:, This study suggests that the initial management of PSP with a small-bore catheter and Heimlich valve can easily be performed by emergency physicians in the community hospital setting and appears safe. A larger study systematically comparing this approach with alternative therapies is needed. [source]

Outcomes of Heimlich valve drainage in dogs

AUSTRALIAN VETERINARY JOURNAL, Issue 4 2009
H Salci
Objective and design Retrospective study of the outcomes of Heimlich valve drainage in dogs. Procedure Medical records of the past 3 years were retrospectively reviewed. Heimlich valve drainage was used in 34 dogs (median body weight 30 ± 5 kg): lobectomy (n = 15), pneumonectomy (n = 9), intrathoracic oesophageal surgery (n = 2), diaphragmatic hernia repair (n = 1), traumatic open pneumothorax (n = 2), bilobectomy (n = 2), ligation of the thoracic duct (n = 1), and chylothorax and pneumothorax (n = 1 each). Evacuation of air and/or fluid from the pleural cavity was performed with the Heimlich valve following thoracostomy tube insertion. During drainage, the dogs were closely monitored for possible respiratory failure. Termination of Heimlich valve drainage was controlled with underwater seal drainage and assessed with thoracic radiography. Results Negative intrathoracic pressure was provided in 29 dogs without any complications. Post pneumonectomy respiratory syncope and post lobectomy massive hemothorax, which did not originate from the Heimlich valve, were the only postoperative complications. Dysfunction of the valve diaphragm, open pneumothorax and intrathoracic localisation of an acute gastric dilatation,volvulus syndrome caused by a left-sided diaphragmatic hernia following pneumonectomy were the Heimlich valve drainage complications. Conclusions The Heimlich valve can be used as a continuous drainage device in dogs, but the complications reported here should be considered by veterinary practitioners. [source]

5 The Contraption: A Low-Cost Participatory Hemodynamic Simulator

ACADEMIC EMERGENCY MEDICINE, Issue 2008
James Ritchie
A hemodynamic simulator assembled from readily-available, inexpensive components can be used to demonstrate complex, clinically pertinent physiologic concepts in a hands-on experiential setting. Our simulator is composed of clear plastic tubing, squeeze bulbs, Heimlich valves, simple plastic connectors, balloons, IV tubing, plastic storage containers, a low-pressure gauge, and a child's water wheel. After a short introduction, student participants reproduce cardiac and systemic vascular function in a coordinated simulation. Normal functional physiology is demonstrated, followed by scripted changes in physiologic conditions. At least four students are simultaneously involved in managing the simulation, including squeezing the bulbs in simulating heart chamber contraction, modifying afterload, preload, and heart rate, and assessing output parameters such as blood pressure, cerebral blood flow, and cardiac output. Using this model, we are able to demonstrate and teach the following concepts: preload, afterload, hypertensive consequences, effects of dysrhythmias, valve disorders, preload criticality with disorders such as tamponade and right ventricular MI, gradual nature of change in physiology, normal compensation despite serious malfunction, relationship of blood pressure with cardiac output, shock state despite normal BP, neurogenic shock, septic shock, hypovolemic shock, cardiogenic shock, cardiac work, maximum blood pressure, vasopressor physiology, diastolic dysfunction coupled with decreased preload or atrial dysfunction, and CHF treatment options. Trainee feedback has been overwhelmingly positive. Trainees at all levels of training, including EMTs and senior EM residents, have grasped complex hemodynamic physiology concepts intuitively after participating with this trainer. [source]