Breathing Circuits and Airway (Garcia) Flashcards
Circle system
- rebreathing system
Non-Rebreathing system
- expired air isn’t recycled
Unidirectional valves
- allow flow in only one direction
- no rebreathing of CO2
- may stick with moisture
- may dislodge from housing
valve most likely to fail
expiratory valve
Non-rebreathing circuits do not have
unidirectional valves
Breathing tubes
- Corrugated-prevents kinking
- transparent plastic
- light (less drag)
- Adult and pediatric size
- two limbs
- coaxial
recognizing funky breathing tubes
One end fitted for a valve
Blue (or green….?) breathing tube has one….
as inspiratory valve
-check by putting on a bag and squeezing, valve that opens is inspiratory valve
Breathing bag
- used as reservoir
- used to deliver breaths
- can be used to count RR
- Some protection against excessive pressure
If pop-off valve stays closed
patient dies from CARDIAC ARREST
Checking for leaks
- canister
- unidirectional valves
- reservoir bag
- hoses
- connections
*Close pop off valve
Circuit system
Advantages
- rebreathing of expired gas after CO2 elimination
- keep heat and moist
- more economic on O2 and inhalent
- Lower O2 flows
- less environmental contamination
circuit system
Disadvantages
- lots of parts
- more likely to leak
- difficult to clean
- not easily moved
- controlled ventilation: hypocarbia
Non rebreathing systems
- Elimination of CO2 by high O2 flow
- Usually patient < 3kg
- High O2 flows: 100-200 mls/kg
- WASTEFUL
- Different systems: Bain system used most
Mechanism that eliminates CO2 in a non-rebreathing circuit
High flow of oxygen
Procedure to check for leaks
- Flow meter OFF
- Close pop-off valve
- Put thumb on patients end of breathing hose
- Press flush valve until pressure gauge reads 30 cm H2O
- Pressure should hold
- Press Flush Valve
- Patient’s end of breathinghose open
- Reservoir bag
- will deflate: inspiratory hose is intact
- if inflates: inspiratory hose is leaking
*Release pressure by opening pop-off valve (do not remove finger)
Leakage up to….. is ok
300 mLs
-turn on flow meter to measure
Checking for leaks in a non-rebreathing circuit
- something about the bag inflating…?
- taking finger off hole high volume gas should blow up the bag if there is a leak….?
Non-rebreathing system
Advantages
- light
- simple
- low resistance
- no need for absorber
- fast change in depth
- inexpensive
Non-rebreathing system
disavantages
- wasteful
- loss of heat and moisture
- pollution
- changes in EtCO2 and gas analyzer readings
Laryngeal anatomy
- Epiglottis
- Arytenoids
- Soft palate
epiglottis
don’t touch it or put pressure on it
-put pressure on base of tongue to make it come down
To verify the ET tube is in the trachea
- Look for the arytenoid cartilages
- Capnography
- Auscultation of both lungs
- Palpate neck: make sure there’s only 1 tube!
- Air movement
- or reservoir bag movement
Intubation complications
- Esophageal Intubation
- gastric distention
- no delivery of gas to lungs
- hypoxia
- Occluded tubes
- Bitten and inhaled tubes
- Bronchial intubation
Over inflation of ET tube can….
destroy trachea
Complications of Laryngospasm
- Can occur at intubation or extubation
- Humans, cats, pigs
- Use local anesthetic before intubation
Cuff inflation steps
- Place tube in trachea (aim for thoracic inlet)
- Connect syringe to pilot balloon
- Place your ear close to animals mouth
- Close pop off valve and hold pressure
- 10-15 cm H2O in cats
- 15-20 cm H2O in dogs
- Add as little air as possible: just enough to stop air leak
- Open pop off valve
*DO THIS BEFORE YOU START INHALENT
