Definitions

Advanced Directives

 

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A legal document describing medical interventions or medical situations that are acceptable or unacceptable to a patient should they be unable to speak for themselves due to critical illness. 

This document provides the health care team, family, and significant others with direction to develop and plan of care in accordance with the patient's wishes and values.

Advanced Directives may be highly specific and situational, or describe a more general set of wishes that can help guide care choices.

Breath Stacking

Breathing stacking is a physician prescribed procedure, so instruction from your health care provider is essential before you perform it.

This procedure involving hyper inflating the lungs over a defined time period to help recruit the base of the lungs for improved gas exchange.   It is typically performed twice daily.

Breath stacking may be ordered as a preventative treatement or as an acute treatment in the event of chest infection. 

Please click here for a printable brochure about breath stacking.

Chronically Critically Ill (CCI)

Patients who experience a prolonged recovery time in the Intensive Care Unit to recover from an acute illness. 

Patients often require weeks to months to wean from mechanical ventilation.  Some patients will not be able to wean from mechanical ventilation

Chronic Ventilation Care Model

A model of health care delivery for patients requiring chronic mechanical ventilation focusing on the following elements:

     i) Preparing patients to manage their own health and direction of care.

    ii) Promoting access to evidence-based clinical decision-making tools.

   iii) Delivering consistent clinical followup that anticipates patient needs

        and makes efficient use of resources.

   iv) Using clinical information systems to anticipate future health needs and

        ensures essential data is accessible to clinicians.

    v) Creating a culture of improvement and patient-centred care within the

        health care system that promote safe, high quality care.

   vi) Encouraging cooperation between acute care facilities and

        community based resources to provide patients care as close to home

        as possible.

Extended Intensive Care Unit

Bay 6 of the Medical-Surgical Intensive Care Unit is dedicated to the care and rehabilitation of patients who are chronically critically ill with an anticipated or established need for prolonged mechanical ventilation (PMV), or those known to need long term ventilation (LTV). 

Goals of care may include improving mobility and independence, reduction and management of long term ventilation, maximizing nutrition, promoting psychological recovery, and reducing monitoring needs until a patient is safe to transfer to another facility.

Invasive Ventilation

Provision of mechanical ventilation through an endotracheal tube inserted in the patient's airway through the nose or mouth, or through a tracheostomy.  A tracheostomy is a breathing tube inserted directly into the trachea through the neck.

Long Term Ventilation (LTV)

 When a patient needs mechanical ventilation that is expected to last anywhere from a few weeks to a lifetime. Ventilation may be non-invasive or invasive.

Non-Invasive Ventilation (NIV)

 Provision of mechanical ventilation by positive airway pressure support using a mask placed over the nose, or nose and mouth.

Prolonged Mechanical Ventilation (PMV)

Invasive mechanical ventilation for more than 21 days, and more than 6 hours per day. 

Secretion Clearance

Physiotherapy techniques and devices designed to help a patient clear secretions in the absence of an effective cough.