1. Stoma/Ostomies and Home Vents By Andrew Gordian

2. Stoma/Ostomies Definition: An opening into the body from the outside created by a surgeon. Which is either temporarily or permanently placed. Definition: An opening into the body from the outside created by a surgeon. Which is either temporarily or permanently placed. Common Types: Common Types: TracheostomiesTracheostomies IleostomiesIleostomies ColostomiesColostomies CystostomiesCystostomies Common Indications: Common Indications: CancerCancer TraumaTrauma InfectionInfection Neonatal complicationsNeonatal complications

3. Stomal Complications Necrosis Necrosis Retraction Retraction Prolapse Prolapse Bleeding Bleeding Stenosis Stenosis Infection Infection Aspiration Aspiration Blockage Blockage

4. Stomal Trivia A tracheotomy is an incision into the trachea that forms a temporary or permanent opening which is called a tracheostomy. The words are commonly used interchangeably, the opening is called a stoma. A tracheotomy is an incision into the trachea that forms a temporary or permanent opening which is called a tracheostomy. The words are commonly used interchangeably, the opening is called a stoma. The tracheostomy is one of the oldest surgical procedures, it can be traced back to 3600 BC The tracheostomy is one of the oldest surgical procedures, it can be traced back to 3600 BC Airport security Airport security Conflicting information: Ventilation during CPR Conflicting information: Ventilation during CPR

5. Stomas and EMS CPR CPR Suctioning Suctioning Intubation Intubation Communication Communication Bleeding Management Bleeding Management Projectile Mucus Projectile Mucus

6. Home Ventilators Definition: Artificial ventilation provided by a mobile or non-mobile machine in ones home. Definition: Artificial ventilation provided by a mobile or non-mobile machine in ones home. Types: Types: Positive-pressurePositive-pressure Negative-pressure (iron lung)Negative-pressure (iron lung) Common Indications: Common Indications: neuromuscular conditionsneuromuscular conditions lung diseases (COPD)lung diseases (COPD) chest wall disorderschest wall disorders scoliosis scoliosis thoracoplasty thoracoplasty obesity hypoventilation syndrome obesity hypoventilation syndrome

7. Home Ventilator Cont. PEEP PEEP Positive End Expiratory PressurePositive End Expiratory Pressure COPD, ARDS, premature newbornsCOPD, ARDS, premature newborns ET/Tracheostomy tubeET/Tracheostomy tube CPAP CPAP Continuous positive airway pressureContinuous positive airway pressure Sleep apneaSleep apnea Nasal maskNasal mask BiPAP BiPAP Bi-level positive airway pressureBi-level positive airway pressure Higher levels of pressureHigher levels of pressure

8. Home Vent Complications Power Power Tubing damage Tubing damage Oxygen depleted Oxygen depleted Stoma complication Stoma complication

9. Home Vents and EMS Family/Staff Family/Staff Hospital transfers Hospital transfers If necessary, use your equipment If necessary, use your equipment Patient comfort Patient comfort

10. Sources http://www.medterms.com/script/main/ http://www.medterms.com/script/main/ http://www.medterms.com/script/main/ http://www.medicinenet.com/colostomy/ http://www.medicinenet.com/colostomy/ http://www.medicinenet.com/colostomy/ http://www.emsresponder.com/ http://www.emsresponder.com/ http://www.emsresponder.com/ http://www.med.umich.edu/mott/pedhomevent/team.html http://www.med.umich.edu/mott/pedhomevent/team.html http://www.med.umich.edu/mott/pedhomevent/team.html Brady, Paramedic Care, Second Edition, Pearson Education, 2006 Brady, Paramedic Care, Second Edition, Pearson Education, 2006 http://www.emedicine.com/ent/topic356.htm http://www.emedicine.com/ent/topic356.htm http://www.emedicine.com/ent/topic356.htm

11. QUESTIONS?