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1

Lacroix, Helene M. A. The pain associated with chest tube removal in children and adolescents. Ottawa: National Library of Canada, 1996.

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2

Atchabahian, Arthur, Christian Laplace, and Karim Tazarourte. Chest tubes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0028.

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Percutaneous chest tube insertion is routinely performed on surgical wards, in the intensive care unit, in the emergency department, and in pulmonary medicine. While it has been shown that trained physicians can safely perform chest tube insertion, severe complications have been described, associated with a lack of proper training and/or an incorrect insertion or management of chest tubes. The proper technique of thoracic drainage is key for safety and effectiveness. Chest tube insertion has been well described, step by step, in the British Thoracic Society guidelines. The level of scientific proof of these recommendations ranges from a high level of evidence (A) to an expert opinion (C) (see Table 28.1).
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3

Mosby. Pal Video: Oxygenation: Chest Tube. Mosby, 1994.

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4

Pierce, Janet Doreen. EFFECTS OF TWO CHEST TUBE CLEARANCE PROTOCOLS ON CHEST TUBE DRAINAGE IN MYOCARDIAL REVASCULARIZATION SURGICAL PATIENTS. 1987.

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5

Parkhomenko, Alexander, Olga S. Gurjeva, and Tetyana Yalynska. Clinical assessment and monitoring of chest radiographs. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0019.

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This chapter reviews the main problems in obtaining portable X-rays in intensive cardiac care unit patients and describes specific features of radiographs taken in the supine anteroposterior position. It also includes a brief review of a systematic, multistep approach of evaluating the quality of radiographic images and describing the chest wall, pulmonary vasculature, the heart and its chambers, the great vessels, and the position of tubes, lines, and devices. This chapter covers the most common conditions for which chest radiographs are useful and provides intensive cardiac care unit physicians, cardiologists, cardiology fellows, and medical students with basic information on water retention, air collection, and lung-related problems. It also focuses on the monitoring of line and device placements (e.g. central venous catheters, tube malposition) and procedure-related abnormalities, which may be apparent on chest X-rays and are helpful for timely diagnoses.
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6

Parkhomenko, Alexander, Olga S. Gurjeva, and Tetyana Yalynska. Clinical assessment and monitoring of chest radiographs. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0019_update_001.

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This chapter reviews the main problems in obtaining portable X-rays in intensive cardiac care unit patients and describes specific features of radiographs taken in the supine anteroposterior position. It also includes a brief review of a systematic, multistep approach of evaluating the quality of radiographic images and describing the chest wall, pulmonary vasculature, the heart and its chambers, the great vessels, and the position of tubes, lines, and devices. This chapter covers the most common conditions for which chest radiographs are useful and provides intensive cardiac care unit physicians, cardiologists, cardiology fellows, and medical students with basic information on water retention, air collection, and lung-related problems. It also focuses on the monitoring of line and device placements (e.g. central venous catheters, tube malposition) and procedure-related abnormalities, which may be apparent on chest X-rays and are helpful for timely diagnoses.
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7

Parkhomenko, Alexander, Olga S. Gurjeva, and Tetyana Yalynska. Clinical assessment and monitoring of chest radiographs. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0019_update_002.

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This chapter reviews the main problems in obtaining portable X-rays in intensive cardiac care unit patients and describes specific features of radiographs taken in the supine anteroposterior position. It also includes a brief review of a systematic, multistep approach of evaluating the quality of radiographic images and describing the chest wall, pulmonary vasculature, the heart and its chambers, the great vessels, and the position of tubes, lines, and devices. This chapter covers the most common conditions for which chest radiographs are useful and provides intensive cardiac care unit physicians, cardiologists, cardiology fellows, and medical students with basic information on water retention, air collection, and lung-related problems. It also focuses on the monitoring of line and device placements (e.g. central venous catheters, tube malposition) and procedure-related abnormalities, which may be apparent on chest X-rays and are helpful for timely diagnoses.
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8

Parkhomenko, Alexander, Olga S. Gurjeva, and Tetyana Yalynska. Clinical assessment and monitoring of chest radiographs. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0019_update_003.

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Abstract:
This chapter reviews the main problems in obtaining portable X-rays in intensive cardiac care unit patients and describes specific features of radiographs taken in the supine anteroposterior position. It also includes a brief review of a systematic, multistep approach of evaluating the quality of radiographic images and describing the chest wall, pulmonary vasculature, the heart and its chambers, the great vessels, and the position of tubes, lines, and devices. This chapter covers the most common conditions for which chest radiographs are useful and provides intensive cardiac care unit physicians, cardiologists, cardiology fellows, and medical students with basic information on water retention, air collection, and lung-related problems. It also focuses on the monitoring of line and device placements (e.g. central venous catheters, tube malposition) and procedure-related abnormalities, which may be apparent on chest X-rays and are helpful for timely diagnoses.
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9

Abouzgheib, Wissam, and Raquel Nahra. Management of pneumothorax and bronchial fistulae. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0124.

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The management of pneumothorax is dependent on size and associated symptoms. A conservative approach is preferred in small and asymptomatic ones. While a large pneumothorax warrants chest tube drainage, small bore could be as effective as large chest tubes and should be used first. The use of bedside ultrasound plays a major role in the acute management of pneumothorax and has an excellent negative predictive value. In some instances, there may be an associated air leak, caused by a broncho- or alveolopleural fistula, which can be managed by chest tube drainage, with or without suction, depending on the severity and extent of lung collapse. With a large air leak, wall suction is needed to keep the lung inflated. In small, intermittent air leaks, suction should be avoided to promote healing of the fistula. With the availability of one-way valves, management of these fistulae became easier, allowing blockage of the airway causing the air leak, and promoting healing and early chest tube removal.
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10

Beed, Martin, Richard Sherman, and Ravi Mahajan. Common emergency procedures. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199696277.003.0017.

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Transfers and retrievalsRapid sequence intubationLaryngeal mask airway insertionNeedle cricothyroidotomyNeedle thoracocentesisIntercostal chest drain insertionArterial line insertionCentral venous accessIntravenous cutdownIntraosseous accessExternal pacingPericardiocentesisFibreoptic bronchoscopyIntra-abdominal pressure measurementLumbar punctureSengstaken–Blakemore tube insertionProne positioning• Intrahospital transfer (e.g. to ICU or to CT scan)....
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11

Fox, Grenville, Nicholas Hoque, and Timothy Watts. Practical procedures. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198703952.003.0020.

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This chapter provides detailed step-by-step descriptions of all the necessary practical procedures in neonatal care. It includes helpful hints and possible complications. Procedures covered include endotracheal intubation, blood sampling, vascular access, CSF sampling, exchange and dilutional transfusion, nasogastric and nasojejunal tube insertion, intercostal chest drain insertion, transurethral catheterization, and suprapubic aspiration of urine.
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12

Arbour, Janice. Care of Chest Tubes. Medcom Inc, 1997.

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13

Soar, Jasmeet, and Jerry P. Nolan. Artificial ventilation in cardiopulmonary resuscitation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0060.

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When cardiac arrest occurs, cardiopulmonary resuscitation (CPR) should be started with chest compressions first. The use of ventilations is determined by the training of rescuers, their ability and willingness to provide rescue breaths, patient characteristics, and the underlying cause of the cardiac arrest. Trained rescuers should give two ventilations after every 30 compressions, or once the airway is secured with a tracheal tube, ventilate the patient at 10 breaths/min without any pause in chest compressions. Rescuers who are unable or unwilling to provide effective ventilation, while awaiting expert help should use compression-only CPR. Ventilations are needed for the treatment of cardiac arrest in children, when arrest is from a primary respiratory cause, or during a prolonged cardiac arrest. Choice of ventilation technique depends on rescuer skills and the airway used. Effective oxygenation and ventilation can be maintained during CPR with a tidal volume of approximately 500 mL given over an inspiratory time of 1 second. Rescuers should give supplemental oxygen in as high a concentration as possible during CPR in order to rapidly correct tissue hypoxia. Once restoration of a spontaneous circulation has been achieved the inspired oxygen should be adjusted to maintain oxygen saturation between 94 and 98%.
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14

Rello, Jordi, and Bárbara Borgatta. Pathophysiology of pneumonia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0115.

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Airway colonization, ventilator-associated tracheobronchitis (VAT), and hospital-acquired (HAP) and ventilator-associated pneumonia (VAP) are three manifestations having the presence of micro-organisms in airways in common. Newer definitions have to consider worsening of oxygenation, in addition to purulent respiratory secretions, chest-X rays opacities, and biomarkers of inflammation. Bacteria are the main causes of HAP/VAP. During hospitalization there’s a shift of airway’s colonizing flora from core organisms to enteric and non-fermentative ones. Macro- and micro-aspiration is the most important source of pneumonia. Endotracheal tube secretion leakage is an important source, serving biofilm as a reservoir. Exogenous colonization is infrequent, but it may contribute to cross-infection with resistant species. Prevention of VAP can be achieved by implementing multidisciplinary care bundles focusing on oral/hand hygiene and control of sedation. Pneumonia develops when micro-organisms overwhelm host defences, resulting in a multifocal process. Risk and severity of pneumonia is determined by bacterial burden, organism virulence and host defences. Innate and adaptive immune responses are altered, decreasing clearing of pathogens. Some deficits of the complement pathway in intubated patients are associated with increased risk for VAP and higher mortality. Micro-arrays have demonstrated specific different immunological signatures for VAP and VAT. Early antibiotic therapy is associated with a decrease in early HAP/VAP incidence, but selects for MDR organisms. Attributable mortality is lower than 10%, but HAP/VAP prolongs length of stay, and dramatically increase costs and use of health care resources.
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15

Yoder, Marianne E. Mastering Clinical Skills: Chest Tubes, Blood Administration, Platelet Administration, Oxygen Administration, Enteral Feeding (Media). Lippincott Williams & Wilkins, 1999.

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16

Prout, Jeremy, Tanya Jones, and Daniel Martin. Thoracic anaesthesia. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199609956.003.0015.

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Pre-assessment of patients for thoracic surgery with prediction of postoperative dyspnoea is important and may determine ‘operability’ of malignancy. Anaesthetic conduct for common thoracic surgical procedures such as thoracotomy, video-assisted thorascopic surgery, mediastinal surgery, and bronchoscopic techniques are described. Techniques for providing one-lung ventilation using double-lumen tubes or endobronchial blockers are discussed along with the physiology of one-lung ventilation, hypoxic vasoconstriction, and techniques to improve oxygenation. Thoracic postoperative care such as pain and chest drain management is included
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17

Goodman, Lawrence R. Imaging the respiratory system in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0078.

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Routine radiographs are not cost effective in the intensive care unit (ICU) setting. Most published guidelines agree that radiographs are worthwhile after insertion of tubes or catheters, and in patients receiving mechanical ventilation. Otherwise, they are required only for change in the patient’s clinical status. Picture archiving and communication systems utilize digital imaging technology. They provide superior quality images, rapid image availability at multiple sites, and fewer repeat examinations, reducing both cost and patient radiation. Disadvantages of picture archiving and communication systems include expensive equipment and personnel required to keep them functioning. The majority of chest X-ray abnormalities in the ICU are best understood by paying careful attention to the initial appearance of the X-ray in relation to the patient’s onset of symptoms and the progression of abnormalities over the next few days.
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18

Task-Based Language Education: From Theory to Practice (Cambridge Applied Linguistics). Cambridge University Press, 2006.

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19

Task-Based Language Education: From Theory to Practice (Cambridge Applied Linguistics). Cambridge University Press, 2006.

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