Required Equipment for Mechanical Ventilation Flashcards
What are the two types of artificial airways?
endotracheal tubes and tracheostomy tubes
Which artificial airway is a specially designed semi-rigid and radiopaque tube?
endotracheal tube
What is the purpose of a cuff on an endotracheal tube?
seals the space between the tube and the trachea so air is directed through the tube into the lower airway, ensuring a predictable tidal volume or pressure
Why do neonatal and small pediatric ET tubes not have cuffs?
the cricoid cartilage offers a sufficient seal once the tube is inserted
Which tube is smaller: a tube used for the orotracheal route or a tube used for the nasotracheal route?
nasotracheal route
What kind of endotracheal tube do guidelines recommend to use?
orotracheal tube
Why is a nasotracheal tube less ideal?
it carries a greater risk of sinusitis and other infections as well as it has increased airway resistance, increased chance of tube kinking, and more difficulty suctioning effectively
What are the 15 things that are necessary for the nurse to have on hand for an intubation?
soft-cuffed ET tubes (variety of sizes)
stylet
topical anesthetic
laryngoscope handle with blade attached and functional light source
magill forceps
suction machine or wall suction
suction catheter kit with sterile gloves
yankauer
syringe
water-soluble lubricant
ET tube holding device
personal protective equipment
sedative medication
stethoscope
CO2 detector
What are magill forceps used for?
to assist with removal of foreign bodies from the airway/pharynx and guiding the tube past the pharyngeal area
When is a tracheostomy indicated?
when there is a patient that requires a prolonged intubation because of failure to wean from the ventilator support
What kind of complications are associated with prolonged use of an ET or nasotracheal tube?
laryngeal damage, ventilator-associated pneumonia, and pressure sores at the lips (or nares) and in the oral cavity
How is the position of the endotracheal tube assessed for proper placement?
auscultation of both lungs fields for equal breath sounds, and then an x-ray is obtained to confirm
What is an immediate method to ensure proper tube placement for an endotracheal tube?
measure the carbon dioxide in exhaled air using a capnography or a disposable CO2 detector
Why are carbon dioxide detectors not ideal for ensuring endotracheal tube placement?
monitors may produce false negatives if the cardiac output is too low to generate the return of CO2 from the blood to the lungs and false positives if the patient has ingested a carbonated beverage prior to intubation
In the adult, an inflated ET tube cuff is necessary for positive pressure mechanical ventilation primarily because it does what?
Seals off the lower airway from the upper airway
