Artificial Airways And Suctioning Flashcards
Endotracheal airways
Inserted by mouth (ot) or nose (nt)
Goes through epiglottis and vocal cords
ONLY USED SHORT TERM 10-14 days
Why use an artificial airway?
Prevent or reverse upper airway obstruction
Orotracheal tube (ot) advantages
Easy to insert
Large diameter decreases work of breathing
Orotracheal tube (ot) disadvantages
Uncomfortable and difficult to secure
Nasotracheal tube (nt) advantages
Easy to stabilize
More comfortable/better tolerated
Nasotracheal tube (nt) disadvantages
Difficult procedure
Limited tube size
Can irritate nasal mucosa
How is a tracheal tube/ tracheostomy inserted
Surgical procedure of tube through the neck directly into the trachea
Advantages of tracheal tube
Direct
Below epiglottis
Easily tolerated
Disadvantages of tracheal tube
Surgical procedure
Potential for infection and hemorrhage
Cuffed tubes
Most common
Filled with air
Balloon seals space between outside of tube and tracheal wall
Allows precise delivery of oxygen
Uncuffed tubes
Used when seal is not needed
Example is pediatrics
Is a trach tube sutured in place?
No, Velcro ties hold it in place
Where is the level of placement of endotrach tubes measured at
Lip line
If tube moves where does it slip into
Right main stem
How long do you have to wait before changing ties of a trach tube
96 hours
How do you change the Velcro if two people are helping
One holds trach in place and one changes the tie
If one person is changing the Velcro on a trach tube how do you do it
Put on the new one completely and then take off the old one
What do you do if the trach comes out?
Assess breathing first
Call for help and open hole
Signs and symptoms of an obstruction with the trach tube
Acute respiratory distress
Cause of infections with a trach
Decreased filtration
Humidification and warming of inspired air
How often should you empty tubing of water and change fluids and tubing
24 hours
What will happen if the trach tubes cuff is over inflated
Tissue necrosis
How can you limit tracheal damage
Place stethoscope over trachea; inflate cuff until no air passes around cuff; slightly deflate until minimal air leak
What causes vocal cord damage
Et tubes left in place more than 10-14 days
Signs and symptoms of a sinus infection with nt tubes
Increased nasal drainage (yellow) fever and headache
Tubes passing through vocal cords prevent
Audible speech
Since they cannot talk with trach tube what should you do for patient
Place close to nursing station and ALWAYS make sure they have a call light available
What indicates suctioning with a trach pt
Unable to clear secretions
What does assessment before suctioning determine
The need and depth
Is suctioning before or after areoles and CPT
After
Why would you do oral suctioning?
Can cough but need mucus removed from mouth
Is oral suctioning sterile
No
Disadvantages of oral suctioning
Causes gagging
How do you auction pharyngeal area
Through mouth or nose
Causes gagging
How do you measure the depth of suctioning
Tip of nose to ear
What do you lubricate suctioning with
Sterile saline
Is orotracheal and nasotracheal suctioning sterile
Yes
How do you measure how far to suction in trach patients
Go until you feel resistance and then pull back 1 cm
What is the resistance you feel in suctioning trach patients
Corina
Biforcation of lungs
All routes for suctioning are treated as sterile except
Oral
Suctioning pressure for adults
110-150
Suctioning pressure for children
95-110 mmHg
Suctioning pressure for infants
50-95 mmHg
Hoe often do you change sterile saline
24 hours
Catheter size
Smallest effective diameter
When do you apply suctioning
On the way out
Suctioning stimulates what
Mucus
When do you oxygenate while suctioning
Before and after
How long can you suction an adult for
10-15 seconds
How long can you suction a child/infant for
5-10 seconds
