Oxygenation, tracheostomy, esophagostomy Flashcards
common cause of upper airwya obstruction in large breeds
laryngeal paralysis
fraction of inspired oxygen should be between
40-50%
excessively high O2% for a long period of time is toxic.
as a principal, your O2 flow rate should be ?
and your fraction of inspired O2 should be ?
2-5 L/min
FiO2 40-50%
transtracheal oxygenation in what cases?
in case of upper airway obstruction, until tracheostomy can be performed.
you just stick a large gauge iv catheter in between the tracheal rings (these are emergency situations).
10-50 ml per kg O2 / min
contraindications for intranasal tubes both feeding and oxygen (4)
head trauma with high ICP
epistaxis
platelet dysfunction or thrombocytopenia
tracheostomy site
between 3rd-4th OR 4th-5th tracheal rings
the diameter of a tracheostomy must never be more than
50% the diameter of the trachea
how is mucus and tracheostomy related?
the air bypasses the upper airways that would warm and humidify it. there is increased mucus production in the trachea due to the cool, dry air entering the tracheostomy.
patient must be oxygenated (min.10 breaths) before mucus aspirtation because aspiration can cause hypoxia and collapse.
the aspiration process must not exceed 12 seconds! because you’re also suctioning oxygen out of the tube with the mucus.
tracheostomy tubes should be cleaned/cleared of mucus every 30 min!
with pericervical traumatic subcut emphysema in cats, you should suspect
tracheal trauma/avulsion etc.
where should thoracocentesis be performed?
depending on air or fluid, upper 1/3rd or lowest 1/3rd of thorax
between 7-9th intercostal spaces
indications for chest tube placement (4)
if a case will require multiple thoracocenteses in a short period of time
thoracic wall injuries or flail chest
after all thoracic surgeries
tumors that cause fluid accumulation in the chest cavity
you can use intercostal blocks or then do it under sedation or GA
when you block 1 intercostal rib space, you are anesthetizing what area?
2 ribs both cranial and caudal from the site of anesthetic are numbed
good idea for flail chests
esophagostomy tube indications (4)
head, craniomaxillofacial trauma
mandibular trauma
anorexia without vomiting
hepatic lipidosis in cats
premeasure the esophagostomy tube from
the mid-cervical esophagus to the level of the 5th-8th intercostal sapce. the tube should NOT reach the stomach (may induce vomtiing reflex).
for esophagostomy tube placement always place your patient
in right lateral recumbency.
The cervical esophagus in cats (and most animals) runs along the left side of the trachea as it travels down the neck.
do xray after palcement to confirm its in esophagus.
feeding via esophagostomy tube frequency/day
calc. nutritional needs of patient, and divide into 4-5 daily portions
always administer a small amount of warm water via the tube before introducing liquid nutrition, and chase with warm as well. NB 1ml/10 sec rule!
