Tubes, Lines and Drains Flashcards
What is the purpose of endotracheal intubation?
Endotracheal intubation keeps the airway open and protected in order to give oxygen, medicine, or anesthesia. It acts as a conduit between the airway and the ventilator.
What is the function of the cuff in an endotracheal tube (ETT)?
The cuff, when inflated to an exact pressure, seals the trachea for positive pressure ventilation and prevents aspiration.
What are the types of endotracheal tubes (ETT)?
Types of ETT include oral or nasal, cuffed or un-cuffed, and double lumen endotracheal tubes.
Where can the carina be located anatomically?
The carina can lie between T5-T7, making it an important anatomical marker for tube and line placement.
What is the ideal position for the tip of an endotracheal tube (ETT) in relation to the carina?
The ideal position of the ETT tip is 3-4 cm above the carina with the head in a neutral position.
What is the minimum and maximum acceptable distance for the ETT tip from the carina?
The ETT tip should be positioned 2-4 cm from the carina, with the ideal being 3 cm above it.
What is the purpose of a double lumen endotracheal tube (DLT)?
A double lumen ETT is used to separate the right lung from the left lung to prevent spillage of blood or pus into the unaffected lung and to allow for independent ventilation during thoracic surgeries.
When is a double lumen endotracheal tube (DLT) used?
DLTs are used in surgeries like aortic aneurysm repair, pneumonectomy, lobectomy, and to ventilate each lung independently at different rates, inflation pressures, or tidal volumes.
What should be included in a chest X-ray to check for a malpositioned ETT?
A neck portion should be included in the chest X-ray to detect a malpositioned ETT or NGT.
Where is a malpositioned endotracheal tube (ETT) more likely to enter?
A malpositioned ETT is more likely to enter the right main bronchus due to its more vertical orientation.
What are the common indications for a tracheotomy?
Airway obstruction (e.g., due to tumors, foreign bodies, or swelling).
Prolonged mechanical ventilation (for more than 7-10 days).
Inability to clear secretions due to weak cough or inability to manage airway.
When is a tracheotomy indicated for ventilation support?
A tracheotomy is indicated for long-term ventilation support, particularly when a patient requires prolonged mechanical ventilation for conditions like respiratory failure.
What is the role of a tracheotomy in upper airway protection?
A tracheotomy is used to bypass upper airway obstruction (e.g., due to tumors, injury, or stenosis) to maintain an open airway.
How does a tracheotomy assist in airway management?
A tracheotomy can assist patients who have difficulty clearing secretions from the airway, such as those with neurological impairments or weakened respiratory muscles.
What is an indication for a tracheotomy in neurologically impaired patients?
A tracheotomy may be indicated in patients with neurological impairments (e.g., stroke, spinal cord injury) that affect their ability to protect their airway or clear secretions.
What are the indications for pleural and mediastinal drains insertion?
To remove air, blood, or fluid from the pleural space & mediastinum. This restores lung expansion and negative pressure in the thoracic cavity.
What is the purpose of an underwater seal in chest drains?
Prevents backflow of air or fluid into the pleural cavity.
What conditions require a chest drain?
Collapsed Lung (e.g., pneumothorax), Lung Infection, Bleeding Around the Lung, Fluid Buildup (e.g., cancer, pneumonia), Surgery (especially lung, heart, or esophageal).
Where should the tip of the chest drain be placed?
The tip of the chest drain should lie above the diaphragm, inside the rib cage, and superimposed over the lung.
What precautions should be taken with chest drains?
Watch the drains don’t get crushed when lowering the bed. NEVER lift the drains above the bed to avoid draining fluid back into the chest.
What is the function of underwater chest drain bottles?
Prevent backflow of fluid or air back into the pleural cavity.
What are pigtail drains used for?
Some pigtail drains are inserted by Interventional Radiology (IR) to target loculated collections.
What is a characteristic of brown Foley-type mediastinal drains?
Brown Foley-type mediastinal drains are not visible on CXR. They are less radiopaque and lack an opaque marker.
What indicates a displaced intercostal drain (ICD)?
Tip and side hole located outside the pleural space (misplacement).
