endotracheal intubation Flashcards
what size Etube will a cat need
3- smallest available
why do we intubate?
ensures airway decreases anatomic dead space prevents aspiration into lungs a means of giving PPV control of anesthetic depth
2 blades for laryngoscopes
mcintosh and miller
where should you put KY jelly?
on the cuff (with finger) this way, the cuff won’t stick to the trachea
supplies needed for ET- besides pt, machine, and restrainer
laryngoscope, 2 tubes, gauze, lube, slip tip syringe, hemostat
preferred way of tying the etube
IV line, rather than gauze or rubber bands
3 types of ETubes
red rubber
vinyl
silicone
which tube deflates manually
vinyl
4 advantages of Vinyl tubes
resists cracking
can see if clogged
wont absorb chemicals
will see condensation
Vinyl tubes are _____ than other tubes
stiffer
red rubber 2 advantages
flexible
cheap
disadvantages of red rubber
cant see fluid, dirty, clogged.
absorbs disinfectants, inhalants
tube may appear cracked when its not
hazard of red rubber and other tubes
kinking/collapsing of tubes
which tube deflates automatically
red rubber tube
high volume/low pressure
vinyl and silicone
low volume/high pressure
rubber
silicone ETubes advantages
smooth and flexible
less irritating to tissues
disadvantage to silicone
expensive
which tubes are flexible
rubber and silicone
most tubes are measured by:
internal diameter
(expressed in mm)
measure ET to reach thoracic inlet
where is the measurement written
side of tube
length of tube is expressed in
cm
diameter of tube is expressed in
mm
inflatable cuff provides
airtight seal between outside wall of tube and inside wall of trachea
inflatable cuff prevents 2 things
leakage of gas from around tube
aspiration of fluids into trachea
the balloon indicates
if the cuff is inflated enough
inflatable cuff- if too much pressure, can cause..
tracheal necrosis
inflatable cuff- if moved in the trachea, can cause..
tracheal damage- lacerations or ruptures
how are ETubes cleaned and disinfected
with a proper cleaning solution (chlorhexidine diluted) and Etube brush
how to properly dry an Etube
hang upside down on ET rack
check cuff inflation after cleaning and before using to prove they can hold air for how long?
3-5 minutes
Rule of Thumb
inject air while applying pressure to reservoir bag until little or no air escapes around tube
must always use a laryngoscope on this species
pigs
use blade of laryngoscope to
depress epiglottis
what species is prone to laryngospasm
cats
what to use on cats
2% lidocaine
- gel 2%
- 0.1ml/lb
if the ETube is too flexible…
use a stylet to reach the tip of the tube
as the cat exhales, the vocal cords are opened, which means..
it is easier to pass the tube.
how to restrain..
lift lips by canines and hold tongue
what side is the esophagus on
the animals left side
most common misplacement of tube
into the esophagus
if the tube is placed in the esophagus
the animal wakes up
feel two rigid tubes instead of one
the patient becomes cynotic if….
endo-bronchial tubation
tube is placed too deeply
to prevent endo-bronchial tubation..
always listen to both lungs
point of murphys eye
extra hole in case one is closed off
how can the etube become obstructed
KY jelly on the holes
kinks
mucous or disinfectant build up
damage to larynx or epiglottis occurs by..
trying numerous times
what is a laryngeal spasm?
vocal cords spasm
least desirable method of confirming you’re in
patting the chest (air from stomach can be misleading)
2 main ways to confirm that you’re in
movement- reservoir bag
feel at thoracic inlet for one rigid tube
confirming you are in: red rubber/vinyl
feel air pass over cheek or finger/see condensation
