1. SVCC Respiratory Care Programs
ARTIFICIAL AIRWAYS
SVCC Respiratory Care Programs

2. SVCC Respiratory Care Programs
Definition
A tube or tube-like device that is inserted through the nose, mouth, or into the trachea to provide an opening for ventilation
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3. Types of Artificial Airways
Oropharyngeal airways
Nasopharyngeal tubes
Orotracheal tubes
Nasotracheal tubes
Tracheostomy tubes
Esophageal obturator airway
Cricothyroid tubes
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4. Indications for Artificial Airways
Relief of airway obstruction -guarantees the patency of upper airway regardless of soft tissue obstruction.
Protecting or maintaining an airway N. have 4 main airway protect. reflexes Pharyngeal reflex th & 10th cranial nerves gag and swallowing
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5. SVCC Respiratory Care Programs
Indications (cont’d)
Reflexes (cont’d) Laryngeal vagovagal reflex will cause laryngospasm 3.Tracheal vagovagal reflex cough when a foreign body or irritation in trachea 4.Carinal cough with irritation of carina
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6. SVCC Respiratory Care Programs
Indications (cont’d)
Facilitation of tracheobronchial clearance
- mobilization of secretions from the trachea requires either an adequate cough or direct suctioning of the trachea
Facilitation of artificial ventilation
- ventilation with a mask should on be used for short periods d/t gastric insufflation
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7. Hazards of Artificial Airways
Infection d/t bypassing the normal defense mechanisms that prevent bacterial contamination
Ineffective cough maneuver
Impaired verbal communication
Loss of personal dignity
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8. SVCC Respiratory Care Programs
Oropharyngeal Airway
Device designed for insertion along the tongue until the teeth &/or gingiva limit the insertion
Lies between the posterior pharynx and the tongue and pushes the tongue forward
Will activate the gag reflex, should use on unconscious patient
Correct sizing of airway is imperative
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9. Hazards of Oropharyngeal Airway
If too small, may not displace tongue or may cause tongue to obstruct airway or may aspirated
It too large, may cause epiglottis impaction
Roof of mouth may be lacerated upon insertion
Aspiration from intact gag reflex
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10. Nasopharyngeal Airway
Located so that it can provide a clear path for gas flow into the pharynx
Is a soft rubber catheter
Can be tolerated by the conscious patient
Useful for patient with a soft tissue obstruction who have jaw injury or spasm of jaw muscles
Proper sizing and insertion
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11. SVCC Respiratory Care Programs
Orotracheal Airway
Used in conditions of, or leading to respiratory failure
Usually the method of choice in emergencies that do not involve trauma to the mouth or mandible
Oral route in usually easiest
Accomplished by using a laryngoscope to directly visualize the trachea
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12. SVCC Respiratory Care Programs
Nasotracheal Airway
More difficult route than oral
Requires a longer and more flexible tracheal tube
Insert through nose by touch and when in oropharynx use larynoscope and forceps (can perform “blind”)
Usually N. T. tube is better tolerated by patient than oral
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13. SVCC Respiratory Care Programs
Tracheostomy Tube
Tracheostomy is performed through the anterior tracheal wall either by the open method or percutaneous method
Performed usually to prevent or treat long-term respiratory failure
Decreases anatomic deadspace by 50%
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14. Complications and Hazards of Tracheostomies
Postsurgical bleeding
Infection
Mediastinal emphysema
Pneumothorax
Subcutaneous emphysema
Stoma collapse (should not be moved or changed first 36 hours)
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15. Esophageal Obturator Airway (EOA)
Place in the esophagus to prevent stomach contents from entering the lungs while the patient is being artificially ventilated
Cuff must be passed beyond carina before inflated
Inflated cuff with 35 cc air
Mask must fit tightly to ensure ventilation
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16. Pharyngealtracheal Lumen Airway (PTL)
Double-lumen airway combining an EOA and an endotracheal tube
Designed to be inserted blindly
Has an oropharyngeal cuff and a cuff that can seal off either the trachea or the esophagus
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17. Other Specialized ET Tubes
Rae Tube, directs the airway connection away from the surgical field
Endotrol Tube, controls the distal tip for intubation
Hi-Lo Jet Tube, for high freq. jet ventilation
Laser Flex Tube, reflects a diffused beam if comes in contact with tube
Endobronchial Tubes
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