MD

Food Poisoning

Common pathogens attributed to food poisoning include Norovirus, Salmonella, Clostridium perfringens, Campylobacter jejuni, Staphylococcus aureus, and Escherichia coli.

Incubation periods depend on the cause, and range from a few hours to days. The clinical presentation associated with food poisoning varies, but typical symptoms include diarrhea, nausea, vomiting, and abdominal cramping.

Staphylococcal food poisoning

Pathogen: Staphylococcus aureus
Gram-positive bacterium
Some strains produce heat-stable enterotoxins that cause staphylococcal food poisoning.  
Transmission: ingestion of preformed toxins in contaminated food

Characteristics

Typically involves a short latency period; resolution of symptoms after 24–48 hours
Bacteria proliferate in inadequately refrigerated food (canned meats, mayonnaise/potato salad, custards).

Incubation period: 1–4 hours

Clinical findings: nausea, vomiting, abdominal discomfort, diarrhea
 

Bacillus cereus infection


Pathogen: Bacillus cereus, a heat-stable, spore-forming  bacterium that produces two different enterotoxins

Transmission: The bacterium grows in heated food that cools down too slowly or is improperly refrigerated. Reheated rice is a common source of infection.

Incubation period and clinical findings

Enterotoxin I (emetic form): 30 min to 6 h after ingestion → nausea and vomiting
Enterotoxin II (diarrheal form): 6–15 h after ingestion → watery diarrhea for 24–48 h
 
Food poisoning from reheated rice - (B. cereus).

TYPES OF TRACHEOSTOMY TUBE

  • A tracheostomy tube may be metallic or nonmetallic

Metallic Tracheostomy Tube

  • Metallic tubes are formed from the alloy of silver, copper and phosphorus
  • Example Jackson’s Tracheostomy tube.
  • Has an inner and an outer tube.The inner tube is longer than the outer one so that secretions and crusts formed in it can be removed and the tube reinserted after cleaning without difficulty. However, they do not have a cuff and cannot produce an airtight seal.
  • Advantages of a double lumen tracheostomy tube are easy to remove,clean and replace inner cannula.
  • Inner cannula should be removed and cleaned as and when indicated for the first 3 days. Outer tube, unless blocked or displaced, should not be removed for 3-4 days to allow a track to be formed when tube placement will be easy.

Nonmetallic Tracheostomy Tube

  • Can be of cuffed or noncuffed variety, e.g. rubber and PVC tubes.

Cuffed Tracheostomy Tubes

  • Pediatric tubes do not have a cuff.
  • Cuffed tubes are used in situation where positive pressure ventilation is required, or when the airway is at risk from aspiration. (In unconscious patient or when patient is on respiration).
  • The cuff should be deflated every 2 hours for 5 mins to present pressure damage to the trachea.

Uncuffed Tracheostomy Tubes

  • It is suitable for a patient who has returned to the ward from a prolonged stay in intensive care and requires physiotherapy and suction via trachea.
  • This type of tube is not suitable for patients who are unable to swallow due to incompetent laryngeal reflexes, and aspiration of oral or gastric con­tents is likely to occur.
  • An uncuffed tube is advantageous in that it allows the patient to breathe around it in the event of the tube becoming blocked. Patients can also speak with an uncuffed tube.

Important

Nonmetallic Tracheostomy Tube - Cuffed tubes are used in situation where positive pressure ventilation is required, or when the airway is at risk from aspiration. (In unconscious patient or when patient is on respiration).

Metallic Tracheostomy Tube -Metallic tubes are formed from the alloy of silver, copper and phosphorus .

  • Example Jackson’s Tracheostomy tube.
  • Advantages of a double lumen tracheostomy tube are easy to remove,clean and replace inner cannula.