Bakit Nga Ba Tinutubo ang Pasyente? (Indications for Intubation for the Layperson)

By: Viktoria Ines Matibag, MD

Siguro naman nakakita na kayo ng mga pasyenteng nakatubo sa mga drama. Maraming maling konsepto na tinuturo katulad na lamang ng: 

1. Nagtutubo lamang ang pasyente kapag wala nang pulso, 
2. Hindi nakakapag salita ang may tubo dahil nga nasa daluyan ito ng hangin,
3. Hindi makakahinga ang pasyente kapag may tubo.

Translation: Don't mistake medical drama series in TV for the real thing. Often times, there are specific important details that is missed out in TV that if you missed it out in real life could result to patients getting harmed. These are the common misconceptions about Intubation: 

1. We only intubate patient if they are already dead or has no pulse 
2. The patient can't express himself if a patient is intubated 
3. The patient can't breathe if he/she is intubated because a TUBE is inserted down his THROAT!

Schizophrenia

PhotoCredit: Mindblog.dericbownds.net

Important Terms

• Schizophrenia
• psychotic mental disorder characterized by profound disturbances in thinking, feeling and behaviour
• one of the most studied, but remains one of the least understood of all the psychopathological disorders
• diagnosis is based on the presence of a set of signs and symptoms
• if patient is diagnosed with schizophrenia and is symptomatic then he is in a psychotic state; if there are no delusions/halllucinations then he is in remission.

Teen Self-Embedding Behavior: A New Challenge for Primary Care Providers

May 10, 2011 — Self-embedding behavior (SEB) in adolescents is a type of severe self-injury presenting a new primary care challenge, according to the results of a retrospective study reported online May 9 and in the June print issue of Pediatrics.

"[SEB] is an extreme form of self-injury involving the insertion of inanimate objects into the soft-tissues, either under the skin or into muscle," write Gregory H. Bennett, BS, from the Department of Radiology, Nationwide Children's Hospital, and the Ohio State University College of Medicine and Public Health in Columbus, and colleagues.

Metal staples are shown on the X-ray of a teenage girl. Courtesy RSNA.

"To date, no case series data on this behavior among adolescents has been described in the pediatric medical literature.... The goal of this study was to define [SEB], develop a clinical profile of adolescents who engage in SEB, and emphasize the importance of rapid, targeted, and effective identification and intervention."

Using a database assessing 600 patients who were percutaneously treated for soft-tissue foreign body removal, the investigators identified adolescents with foreign bodies self-embedded in the soft tissue and described their demographics, psychiatric diagnoses, and characteristics of SEB.

The Last Hours of Living: Practical Advice for Clinicians

Clinical competence, willingness to educate, and calm and empathic reassurance are critical to helping patients and families during a loved one's last hours of living. Clinical issues that commonly arise in the last hours of living include the management of feeding and hydration, changes in consciousness, delirium, pain, breathlessness, and secretions. Management principles are the same whether the patient is at home or in a healthcare institution. However, death in an institution requires accommodations that may not be customary to assure privacy, cultural observances, and communication. In anticipation of the event, inform the family and other professionals about what to do and what to expect. Care does not end until the family has been supported with their grief reactions and those with complicated grief have been helped to get care.

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