Airway devices Flashcards
It is a flexible plastic tube that is inserted into the patient mouth into the trachea to help sustain a spontaneous breathing.
Endotracheal Tube
Process of inserting ET tube in to the airway of the patient and is most frequently performed type of intubation
Endotracheal In`tubation
This ET tube requires an injection of your pressurized `air into the balloon to create a seal against the inside wall of your airway
Cuff ET tube
This ET tube is recommended for children less than 8 years old to prevent narrowing of trachea.
Uncuff RT tube
Average distance of the teeth to the carina of the ET tube
- 27 cm in MALE
- 25 cm for FEMALE
The tip of ET tube should rest what cm above the carina?
2 - 4 cm above carina
It protects your patient from aspiration and provide help in giving your patient a positive airway pressure.
ET cuff
The cuff can be monitored by using what type of instrument? connected to pilot balloon
Manometer
Normal cuff pressure
25 - 35 cmH2O
Indications of inserting ET tube:
- Relief upper AW obstruction
- Protect patient airway
(1) Pharyngeal reflex: gag and swallowing
(2) Laryngeal reflex: laryngospasm
(3) Tracheal reflex: coughing when trachea is
irritated
(4) Carinal reflex: coughing when carina is irritated - Facilitation of tracheal suctioning
- Assistance in manual ventilation or mech vent.
This reflex is responsible for preventing us from chocking
gag reflex
This reflexes preventing material in entering in upper airway
Laryngeal reflex
This reflex work when your trachea is irritated
Tracheal reflex
Hazards of ET tube:
- loss the ability to talk
- loss patient ability to eat using mouth
- tube occlusion with inspissated secretions
- damage vocal cord
Complications of ET tube:
- poorly tolerated by conscious and semi-patient
- gagging caused by tube irritation
- harder to patient to communicate
- patient may bite the tube that may cause occluding airflow
- erodes, corner of patient mouth
- stimulates oral secretion
Physician used this in inserting ET tube or shape the ET tube to make it easier to be installed
stylet
It is a surgical opening in the neck and trachea that provides access for the insertion of an artificial airway known as a tracheostomy tube
Tracheostomy
It is a hole in the trachea without the tube in place
Stoma (2nd or 3rd tracheal ring)
It is an artificial airway that bypasses upper airway, and is inserted directly into the trachea via stoma
Tracheostomy tube
Indications of Tracheostomy
- the patient will require mechanical ventilation for more than one or two weeks.
- the patient can’t manage their own secretions and require frequent tracheal suctioning
- the patient has a difficult airway or sudden trauma/swelling in their upper airway and attempts to intubate via the endotracheal have failed
Risk and complications of tracheostomy
- obstruction to the tracheostomy tube from secretions or blood clots that prevent ventilation
- infection
- accidental decannulation of the tracheostomy tube
This type of Tracheostomy tube is developed for patients require positive pressure ventilator and airway protection.
Cuffed tracheostomy tube
This type of tracheostomy is used when the patient no longer needs positive pressure ventilation and has no significant aspiration risk. The tube is still for access to chest secretions for bypass an upper airway obstruction.
- often used in neonatal patient, or for patient who doesn’t need mech vent and can manage their secretion effectively
Uncuffed tracheostomy tube
What will happen if the pressure is high, or exceeds 20 - 30 cmH2O
It causes tracheal stenosis or damaged the airway
What will happen if the pressure is low, or exceeds < 20 - 30 cmH2O
- Reduce the effectiveness of the delivery of positive pressure ventilation.
- patient airway is NOT FULLY PROTECTED against aspiration of secretion
it is a special type of tracheostomy tube that has an opening above the cuff which allows the airflow to pass so that a patients able to talk with the airway in place
- allowing patient to talk
Fenestrated Tracheostomy tube
It can help restore airway patency and maintain adequate ventilation, in particular, when using a bag-mask device
Pharyngeal airways
This type of phrayngeal airway known as nasal horn or nasal trumpet
- it is inserted through one of the nares and past the turbinates
Nasopharyngeal airway
ADVANTAGES of using Nasopharyngeal airway:
- can be used for the SEMI-CONSCIOUS VICTIM
- can be used in situations where the victim has extensive injury to the mouth & lower jaw
- can be used in the patient with INTACT GAG REFLEX
- DOES NOT REQUIRE HYPEREXTENSION of neck during insertion
- patient’s WITH SEIZURE
DISADVANTAGES of nasopharyngeal airway:
- sever nasal bleeding
- irritation of nares
- Suspected basilar skull fractures
- trauma to nose
- resistance is met when attempting to advance the device
this type of pharyngeal airway is indicated for the conscious and non-responsive patient and has difficulty maintaining a paten upper airway
Oropharyngeal airway
Two common oropharyngeal airway designs:
- GUEDEL AIRWAY
2. BERMAN AIRWAY
Type of oropharyngeal airway that has 2 horizontal place connected
berman airway
Type of oropharyngeal airway that is designed with one smooth channel through the center
Guedel airway
ADVANTAGES of oropharyngeal airway
- prevent airway obstruction by the tongue
- to be used as a bite block
- to increase the effectiveness of bag/mask ventilation
Contraindication of oropharyngeal airway
- a conscious patient with a gag reflex
it is a type of airway device with a small, triangular-shaped inflatable mask that is secured to a tube, similar in size to an ETT
Laryngeal mask airway
Purpose of laryngeal mask airway:
To prevent gastric aspiration while providing a patient airway
ADVANTAGES of Laryngeal mask airway
- Can be quickly inserted to provide ventilation when bag-mask ventilation is not adequate and ET intubation cannot be accomplished
- The LMA ventilates equally as well as an Et tube
- training is simpler than for ET intubation
- there is no risk of esophageal or bronchial intubation
- there is less risk of trauma to the airway than with ET intubation.
Contraindications of LMA
- patient is conscious or resists placement of LMA
- patient is known to have or might have food in stomach
- patient has GERD
This type of airway device is a twin lumen device airway that is inserted blindly into the oropharynx and advanced into the esophagus or trachea
- feature similar to ETT
Combitube airway
