ET intubation( Endotracheal Intubation)
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Endotracheal intubation involves placing a flexible plastic tube into the trachea to maintain an open airway or administer drugs. It is used to administer oxygen, remove secretions, ventilate the lungs, and treat respiratory failure or hypoxemia. Indications include central nervous system depression, neuromuscular disease, chest wall injury, upper airway obstruction, aspiration prophylaxis, and spinal fractures. The procedure involves positioning the patient, using a laryngoscope to view the vocal cords, inserting the tube, inflating a cuff if present, securing and connecting the tube to a ventilator or Ambu bag.
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endotrachial intubation
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Endotracheal intubation involves placing a flexible plastic tube into the trachea to maintain an open airway or administer drugs. It is used to administer oxygen, remove secretions, ventilate the lungs, and treat respiratory failure. Indications include CNS depression, neuromuscular disease, chest injuries, airway obstruction, and aspiration risk. The procedure requires a laryngoscope, ET tube, suction equipment, and securing the tube once placed to ventilate the lungs. Complications can include injury and intubation in the wrong airway.
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Thoracentesis (thor-a-sen-tee-sis) is a procedure that is done to remove a sample of fluid from around the lung.
The lung is covered with a tissue called the pleura. The inside of the chest is also lined with pleura.
The space between these two areas is called the pleural space.
This space normally contains just a thin layer of fluid, however, some conditions such as pneumonia, some types of cancer, or congestive heart failure may cause excessive fluid to develop (pleural effusion).
Thoracentesis, also known as pleural fluid analysis, is a procedure in which a needle is inserted through the back of the chest wall into the pleural space (a space that exists between the two lungs and the anterior chest wall) to remove fluid or air.
Pleural fluid analysis is the microscopic and chemical lab analysis of the fluid obtained during thoracentesis.
IndDiagnostic: determination of pleural effusion etiology (e.g. transudative versus exudative) usually requires the removal of 50 to 100mL of pleural fluid for laboratory studies. Most new effusions require diagnostic thoracentesis, an exception being a new effusion with a clear clinical diagnosis (e.g. CHF) with no evidence for superimposed pleural space infection
Therapeutic: reduce dyspnea and respiratory compromise in patients with large pleural effusions. This is typically achieved by removing a much larger volume of fluid compared to the diagnostic thoracentesis
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Chest tubes
Chest tubes are hollow plastic tubes inserted into the chest cavity to drain fluid, blood, or air. They use suction to drain into a collection chamber and are removed when drainage becomes minimal. The Atrium Oasis chest drain system used at WCMC provides dry suction drainage and has indicators to monitor suction and detect air leaks."
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This document discusses different types of endotracheal tubes. It begins with a brief history of endotracheal intubation and then describes the standard design features of endotracheal tubes including the patient end, curvature, markings, materials, sizes, tube cuffs, and machine end. It then discusses several speciality endotracheal tubes designed for specific purposes like neonatal resuscitation, microlaryngeal surgeries, nasal intubation, and monitoring electrodes during laryngeal surgery. In total, over 15 different endotracheal tube varieties are outlined.
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Chest tubes are inserted to drain fluid or air from the pleural space and allow the lung to re-expand; they are connected to underwater seal drainage to maintain suction and allow fluid to drain via gravity while monitoring for fluctuations, bubbles, and output; nurses must carefully monitor patients with chest tubes and the drainage systems to ensure proper functioning and prevent complications.
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The document discusses nasogastric intubation, which involves inserting a plastic tube through the nose and down into the stomach. It describes the gastrointestinal tract and its functions. Nasogastric intubation is used to treat conditions like intestinal obstruction, vomiting, and drug/chemical poisoning. Placement of the tube requires lubrication and inserting it while the patient swallows. Confirmation is done by injecting air and listening with a stethoscope or getting an x-ray. Removal involves having the patient take a deep breath while quickly pulling out the tube. Potential complications include nose bleeds, sinusitis, and esophageal perforation.
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Tracheostomy Tube
Tracheostomy is a surgical procedure that creates an opening in the trachea to allow for an alternative airway. It is commonly performed when a patient requires prolonged intubation or has an airway obstruction. There are two main techniques for tracheostomy - open and percutaneous. Complications can include bleeding, infection, and injury to surrounding structures like the vocal cords. Tracheostomy tubes come in various shapes, sizes, and materials like PVC or silicone. Factors like the patient's anatomy and needs determine the appropriate tube type and size for safe and effective ventilation and airway management.
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This document discusses the insertion of a nasogastric tube. It defines a nasogastric tube as a tube inserted into the stomach through the nose for therapeutic or diagnostic purposes. The document outlines the indications for nasogastric tube insertion including artificial feeding, administration of oral medications that cannot be swallowed, gastric lavage, correcting fluid and electrolyte imbalances, and obtaining gastric samples. It provides details on the equipment, patient preparation, tube placement procedure including confirming proper placement through auscultation and pH testing of aspirated gastric contents, and recording and reporting.
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The bougie is an intubation aid that is inserted through the vocal cords to help guide placement of an endotracheal tube. The tracheal light uses transillumination to help visualize placement of an endotracheal tube in difficult airways. The laryngeal tube is a new supraglottic airway device made of silicone that provides an alternative to endotracheal intubation or laryngeal mask airway placement. The combitube is a double lumen tube that can provide ventilation whether placed in the trachea or esoph
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The document describes the process of nasogastric intubation to insert a feeding tube through the nose and esophagus into the stomach. It details the indications for NG tube placement, contraindications, proper insertion technique including confirming proper placement, securing the tube, potential complications, and removal steps. The key aspects covered are preparing the patient, lubricating and measuring the tube, inserting it along the floor of the nose and having the patient swallow to guide it into the stomach, confirming placement through auscultation or pH testing of aspirated gastric contents, and removing it by having the patient take a deep breath while quickly pulling out the tube.
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This document discusses hemodynamic monitoring in pediatrics. It begins with definitions of hemodynamics and hemodynamic monitoring. Both invasive and noninvasive monitoring methods are described, including arterial blood pressure monitoring, central venous pressure monitoring, and pulmonary artery catheterization. Complications of invasive methods are outlined. Normal hemodynamic parameters for children are provided. The document emphasizes the importance of hemodynamic monitoring in critically ill children to guide treatment and optimize tissue perfusion and oxygen delivery.
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This document provides information on tracheostomies including definitions, functions, indications, types of procedures, techniques, care, complications and emergency airway management. A tracheostomy is a surgically created opening in the trachea to allow breathing when the oral airway is compromised. It can be an alternative breathing pathway, protect the airways, allow suctioning of secretions, and enable positive pressure ventilation. Indications include respiratory obstruction, retained secretions, and respiratory insufficiency. Types include emergency, elective, permanent, and percutaneous tracheostomies. The technique, care, complications, and procedures for managing acute airway obstruction are described in detail.
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This document provides an overview of thoracentesis, including:
- Definition, indications, contraindications, techniques/procedure, materials, and complications of thoracentesis.
- Thoracentesis is a procedure to remove fluid from the pleural space, either for diagnostic purposes or to relieve symptoms. It is indicated for large pleural effusions or those requiring diagnostic analysis.
- Potential complications include pneumothorax, hemothorax, organ injury, and infection, though minor complications like pain or dry tap are more common. Proper patient preparation, anesthesia, positioning, and sterile technique are emphasized to reduce risks.
Endotracheal intubation
Endotracheal intubation involves placing a plastic tube into the trachea to maintain an open airway. It is used to administer oxygen, remove secretions, ventilate the lungs, and treat respiratory failure. Indications include respiratory muscle fatigue, respiratory failure, neurological issues, chest injuries, and airway obstruction. The procedure requires proper positioning, use of a laryngoscope to visualize the vocal cords, and passing the tube through the cords into the trachea while visualizing placement. Correct tube placement must be confirmed before securing and connecting to a ventilator. Complications can include tube misplacement, injury, infection, or lung damage.
Hemodynamic Monitoring
Hemodynamic monitoring involves the invasive measurement of pressures within the heart and vessels to assess cardiovascular function and tissue perfusion. It utilizes a catheter connected to a transducer and monitor. Catheters can be placed in the pulmonary artery via the jugular or subclavian vein, in the right atrium, or in arteries like the radial or femoral. This allows the direct measurement of pressures in these areas to guide treatment for issues like shock. Complications can include infections, arrhythmias, or embolisms, so the insertion site must be carefully monitored.
Bladder irrigation
Urinary bladder irrigation involves flushing the bladder with a liquid solution to cleanse it and maintain catheter patency. Common purposes include cleaning out debris, bacteria, and blood from the bladder. Solutions used include sterile water, saline, glucose, and various antiseptics. The procedure involves setting up sterile tubing connected to an irrigation solution and catheter, then slowly instilling and draining the fluid while monitoring for complications like bleeding. Records must be kept of the solutions, amounts, and characteristics of drainage.
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Bougie, trachlite , laryngeal tube , combitube , i gel ,truview
Similar to ET intubation( Endotracheal Intubation)
Endotracheal intubation
Endotracheal intubation involves placing a flexible plastic tube into the trachea to maintain an open airway or administer drugs. It is used to administer oxygen, remove secretions, ventilate the lungs, and treat respiratory failure. Indications include CNS depression, neuromuscular disease, chest injuries, airway obstruction, and aspiration risk. The procedure requires a laryngoscope, ET tube, suction equipment, and securing the tube once placed to ventilate the lungs. Complications can include injury and intubation in the wrong airway.
Endotracheal intubation
Endotracheal intubation involves inserting a tube into the trachea through the mouth or nose. It is done to administer oxygen, remove secretions, promote airway patency, or assist with breathing difficulties. The document discusses indications for intubation, equipment needed, steps for performing intubation, post-intubation care, complications, and the importance of documentation.
Endotracheal intubation
INTRODUCTION
Intubation is required when a patient has difficulty breathing and needs ventilatory assistance.
A hollow tube is inserted into the trachea and held in place by a small inflated balloon.
INDICATION OF ENDOTRACHEAL TUBE INSERTION
ACUTE RESPIRATORY FAILURE
CENTRAL NERVOUS SYSTEM DEPRESSION
NEUROMUSCULAR DISEASE
PULMONARY DISEASE
CHEST WALL INJURY
UPPER AIRWAY OBSTRUCTION
ASPIRATION PROPHYLAXIS
FRACTURE OF CERVICAL VERTEBRAE WITH SPINAL CORD INJURY.
Equipment required
Suction catheter
Oxyen, Bag valve mask(Ambu bag)
Laryngoscope (two curved blades and straight blade)
Stylet /bougie
Endotracheal tubes (preferred size and smaller)
Magills forceps
Drugs (muscle relaxant, sedative)
Xylocaine jelly
Syringe for cuff inflation
Tape to secure tube
PROCEDURE
Assess the patient’s heart rate, LOC and respiratory status
Remove the patient dental bridgework and plates
Prepare equipments
Complications of intubation
Early complications
Trauma, e.g. haemorrhage, mediastinal perforation
Haemodynamic collapse, e.g. positive pressure ventilation, vasodilation, arrhythmias or rapid correction of hypercapnia.
Tube malposition, e.g. failed or endobronchial intubation.
Later complications
Infection including maxillary sinusitis if nasally intubated
Cuff pressure trauma (maintain cuff pressure <25cmH2O)
Mouth /Lip trauma
Water Seal Drainage
Chest drains also known as under water sealed drains (UWSD) are inserted to allow draining of the pleural spaces of air, blood or fluid, allowing expansion of the lungs.
Seminar on Tracheostomy, types and its Complications.
Tracheostomy is a surgical procedure that creates an opening in the trachea to allow direct access to the breathing tube. It is indicated for conditions that cause respiratory obstruction, excess secretions, or respiratory insufficiency. The procedure involves making an incision through the neck and inserting a tracheostomy tube. Care is required after surgery to prevent complications like bleeding, infection, or tube displacement. Tracheostomy tubes are eventually removed once the underlying condition is resolved and the patient can breathe safely through the mouth and nose.
endotracheal suctioning.pptx
This document provides information on endotracheal suctioning. It defines endotracheal suctioning as removing secretions from the tracheobronchial tree through an endotracheal tube using mechanical suction. The purposes are to maintain a clear airway, prevent infections, provide effective ventilation, and stimulate coughing. The document outlines the assessment, patient preparation, equipment, procedure, documentation, and complications of endotracheal suctioning.
advancedneonatalprocedures-200429120529.pdf
This document discusses several advanced neonatal procedures including endotracheal intubation, mechanical ventilation, and gastric gavage. It provides details on how to perform endotracheal intubation including indications, equipment, patient positioning, techniques, and complications. It also describes the purposes of mechanical ventilation including ventilation, oxygenation, and gas exchange. Various modes, settings, and indications for mechanical ventilation are outlined. The document is a reference for nursing students on performing important respiratory procedures in neonates.
Advanced neonatal procedures
This document discusses various advanced neonatal procedures including endotracheal intubation, mechanical ventilation, and gastric gavage. It provides details on how to perform endotracheal intubation including indications, equipment, patient positioning, techniques, and complications. It also describes the purposes of mechanical ventilation including ventilation, oxygenation, and gas exchange. Various modes, settings, and indications for mechanical ventilation are outlined.
Oxygenation
Oxygenation is the process of oxygen delivery to tissues through respiration. Oxygen therapy provides supplemental oxygen to patients through various devices to treat hypoxemia and hypoxia. It aims to facilitate normal tissue metabolism and correct low blood oxygen levels. Factors like physiological changes, development, lifestyle, and environment can impact oxygenation. The document outlines oxygen administration devices, methods of delivery including nasal cannulas and masks, and the steps for proper oxygen therapy preparation, procedure, and aftercare of patients and equipment.
Tracheostomy
TRACHEOSTOMY IN FULL DETAILS......
TRACHEOSTOMY, EMERGENCY TRACHEOSTOMY, SECURE AIRWAY, PERCUTANEOUS TRACHEOSTOMY, HISTORY OF TRACHEOSTOMY, PROCEDURES, GIGGS TECHNIQUE,VARIOUS TYPES OF TRACHEOSTOMY, TRACHEOSTOMA, DECANNULATION, INDICATIONS, CONTRAINDICATIONS, CRICOTHYROIDOTOMY, MINITRACHEOSTOMY, TRACHEOSTOMY TUBES, COMPLICATIONS OF TRACHEOSTOMY.
Management_of_Epistaxis_Goal_is_Control
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The nasal septum Cummings 2021Chapter 29
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DCRSXisapptforophthalmologistdepartmetofmedical
The document describes the procedure of endoscopic dacryocystorhinostomy (DCR). It involves using an endoscope to create an opening between the lacrimal sac and nasal cavity to drain tears, bypassing an obstructed nasolacrimal duct. Key steps include making mucosal flaps in the nose and lacrimal sac, removing bone using punches and burrs to fully expose the sac, and approximating the flaps to marsupialize the sac into the nose. Silicone intubation and mitomycin C may be used to promote healing and prevent scarring. Postoperative care includes antibiotics, steroids, and follow-up to assess drainage.
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The document describes the procedure of endoscopic dacryocystorhinostomy (DCR). It involves using an endoscope to surgically create a passage between the lacrimal sac and the nasal cavity by removing bone and mucosal flaps. Key steps include making incisions in the nasal mucosa and bone over the lacrimal sac, elevating mucosal flaps, and using punches and rongeurs to carefully remove bone and expose the full lacrimal sac for drainage into the nose. The procedure aims to bypass blockages in the tear drainage system endoscopically without external incisions for improved cosmesis over external DCR.
Guideline for airway management3
apply cricoid pressure
2. Make a 2 cm vertical incision through skin and membrane
3. Insert tube through incision into trachea
4. Inflate cuff and ventilate
5. Secure tube and confirm position
6. Consider securing airway definitively later
7. Consider transfer to theatre for definitive airway
Surgical Tubes used in General Surgery
This document discusses various types of surgical tubes used in clinical practice. It describes chest tubes, which are placed in the pleural space to drain air or fluid from the lungs. It also covers tracheostomy tubes, which are inserted into the trachea through the neck to relieve airway obstruction. Additionally, it outlines nasogastric, gastrostomy, and jejunostomy tubes that are used for feeding or drainage of the stomach and small intestine.
airway management
The document provides an overview of airway anatomy and management techniques. It describes the anatomy starting from the nose down to the trachea. It then discusses factors that can make the airway difficult and techniques for assessing the airway. It explains various airway management techniques including mask ventilation, use of airways, laryngoscopy, intubation, and alternative techniques like LMA and needle cricothyrotomy.
Epistaxis
Epistaxis, or nosebleeds, are a common medical issue. The nasal cavity receives its blood supply from both the internal and external carotid arteries through various vessels. Common causes of epistaxis include weather changes, NSAID use, alcohol consumption, and hypertension. Treatment depends on the severity and location of the bleeding. Minor anterior bleeds can be treated by cauterization, while more severe or posterior bleeds may require nasal packing, endoscopic localization and cauterization of the bleeding vessel, or ligation of the main arterial supply through surgical procedures.
Basic life support among undergraduate students
A study to evaluate the effectiveness of planned teaching programme on level of knowledge regarding basic life support among undergraduate B.sc 1st year students at gurukul mahila mahavidyalaya, kalibadi, raipur, (C.G.)
Tracheostomy -INDICATIONS,CONTRAINDICATIONS,PROCEDURE,COMPLICATIONS
Tracheostomy is a surgical procedure that creates an opening in the trachea to allow direct access to the breathing tube. It is one of the oldest surgical procedures, dating back to the 15th century. Tracheostomies can be temporary or permanent depending on the clinical situation and underlying condition. Potential complications include bleeding, infection, and damage to nearby structures like the thyroid cartilage. Care after tracheostomy involves dressing changes, tube changes or decannulation as appropriate for the patient's recovery.
Similar to ET intubation( Endotracheal Intubation) (20)
Seminar on Tracheostomy, types and its Complications.
Seminar on Tracheostomy, types and its Complications.
Tracheostomy -INDICATIONS,CONTRAINDICATIONS,PROCEDURE,COMPLICATIONS
Tracheostomy -INDICATIONS,CONTRAINDICATIONS,PROCEDURE,COMPLICATIONS
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ET intubation( Endotracheal Intubation)
- 2. DEFINITION Endotracheal intubation is the placement of a flexible plastic tube into the trachea to maintain an open airway or to serve as a conduit through which to administer certain drugs.
- 3. PURPOSE To administer oxygen To remove secretions To ventilate the lungs. To establish and maintain airway To treat acute respiratory failure and persistent hypoxemia.
- 4. INDICATIONS CNS Depression. Neuromuscular disease. Chest wall injury. Upper airway obstruction. Aspiration prophylaxis. Fracture vertebrae and spinal cord .
- 5. ARTICLES REQUIRED Sand Bag /Towelroll Suction apparatus with Tubing Suction Catheter Ambu bag and Mask Oxygen source and Tubing Laryngoscope with appropriate size blade Magill’s Forceps
- 6. Cont. .Endo tracheal tube of appropriate size Stylette Xylocaine jelly Plastic syringe 10ml Oral airway Cotton Tape Gloves Face mask
- 7. Different sizes of cuffed and plain ET Tubes
- 12. Technique of Intubation Raise the head by 5 cm with a block ortowel roll
- 13. POSITION FOR INTUBATION Position your patient in supine position with head extended by keeping sand bag or towel role under the neck.
- 15. PROCEDURE Hold the laryngoscope with LEFT hand irrespective of dominant hand Open the mouth with right hand index finger with support of thumb. Introduce Laryngoscope from right angle of mouth Shift the tongue to left and go in. Press over tongue. See epiglottis and lift it. Watch for vocal cord
- 16. Procedure cont..
- 18. Cont… Take the tube in right hand Introduce under vision Confirm placement by auscultation If tube is cuffed inflate the cuff
- 19. Cont. .Connect the source to tube Confirm the position of tube a)by auscultation b) by chest expansion c) by bag movement Fix the tube with adhesive.
- 21. Cont. . Connection to ventilate with -ambu's bag -anesthesia machine -ventilator
- 22. ENDO TRACHEAL TUBE IN PLACE
- 23. POST PROCEDURE CARE Place the patient in lateral position Arrange for chest X- ray in order tocheck placement of ET Tube Apply endotracheal suctioning as needed. Watch for chest movements,ET Tube
- 24. COMPLICATIONS Tube in esophagus Endo bronchial Intubation Trauma to lips and tooth Laryngeal and tracheal Injury Baro trauma to lungs Bleeding Tracheities Pulmonary infection and sepsis