VAP in trauma patients

[rwolfer at aol.com]

we now use prn sedation instead of drips on the vast majority of our pts, unless dictated by need by NS or need for chemical paralysis. we have found that these pts are extubated much sooner and the incidence of VAP is very low. In fact in the last 6 months have only seen it on those pts on continous sedative drips.


Rebecca Wolfer, MD, FACS, FCCP
Associate Professor, Marshall University School of Medicine
Dept of Surgery
Director Thoracic Surgery
Director, Surgical Critical Care Cabell Huntington Hospital
Director, Trauma Cabell Huntington Hospital


-----Original Message-----
From: cathy armstrong <cathyarmstrong1 at googlemail.com>
To: Trauma &amp, Critical Care mailing list <trauma-list at trauma.org>
Sent: Tue, 6 May 2008 12:44 pm
Subject: Re: VAP in trauma patients



we are not usung those etts, but I am trying toi source an ETT with a small
seperate port above the cuff-pharyngeal port so we can instil
chlorhexidine/alcohol prep, small volumes 2-3 mls. we have started using
oral toilet with the prep and withcombined with  the implementation of vent
care bundle of
1. 35 degreehead up tilt
2. sedation hold daily as tolerated
3.peptic ulcer prophylaxis
4. dvt prophylaxis
seems to give us better stats( of course there are exclusion criteria for
different clinical situations)
c. armstrong

On Mon, May 5, 2008 at 6:50 PM, Schlenker, Anita <
Anita.Schlenker at tenethealth.com> wrote:

> Are any of you using internally coated endotracheal tubes with silver
> sulfadiazine to prevent VAP in your trauma patients?
> Anita Schlenker, RN
> Trauma Program Manager
> Doctors Medical Center - Modesto
> 1441 Florida Ave
> Modesto, CA 95350
> 209-576-3776
>
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