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Modified over 6 years ago
Airway obstruction Trauma foreign bodies inflammation hematomas CNS disease secretions Drug overdose Infections glottitis Obstructive sleep apnea
Airway Protection May be impaired for similar reasons May decompensate with addition of varied bolus sizes and consistencies
Artificial Airways Rationale upper airway obstruction loss or impairment of airway protective reflexes inability to maintain clear airway (secretions) ventilator support
Maintaining a Patent Airway Maintaining a clear airway secretions inability can have drastic effects lung collapse hypoxemia laborious breathing
Skills needed for effective clearing mechanism (cough) deep breath competent glottis generate increased pressure vital capacity of 15 cc/kg
Ventilator Inability to maintain pulmonary function Apnea Acute ventilator failure increased CO 2 decreased pH Hyperventilation tracheostomy tube is required for ventilator function
Disadvantages Airway contamination Diminished cough Inability to vocalize Loss of control Increased difficulty swallowing
Types of Artificial Airways Endotracheal tube emergency surgical ICU Cricothyroidotomy emergency
Nasotracheal nonpreferred method oral cavity surgeries Tracheostomy long term intubation greater than 10 - 21 days
Tracheostomy Advantages lower risk of laryngotracheal injury improved comfort/mobility improve airway stabilization allows for oral nutrition improved secretion clearance
Potential problems (24 hours) pneumothorax hemorrhage subcutaneous emphysema infection tube displacement
Problems (long term) aspiration swallow dysfunction increased incidence of RTI and pneumonia tracheal stenosis a/o malacia TE fistula granulomas obstruction
Tracheostomy tubes Inner cannula Outer cannula Phalange Obturator Pilot balloon Cuffs high volume, low pressure low volume, high pressure
Changing trach tube malfunction infection more flexible weaning
Suctioning Complications hypoxemia hypotension slow heart rate prolonged coughing which slows rate arrhythmia lung collapse mucosal damage
Trach tube types Cuffed Cuffless Fenestrated Communication tubes Tracheal buttons
Advanced Airway Management
Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc. Chapter 30 Care of Patients Requiring Oxygen Therapy or Tracheostomy.
Oxygenation By Diana Blum MSN NURS Oxygen is clear odorless gas 3 components for respiration Breathing Gas exchange Transportation Structures Upper.
Managing the Artificial Airway RC 275 Tracheotomy/Tracheostomy When intubation can’t be done or the need for the airway is indefinitely long Traditional.
Upper Airways - Terms Endotracheal Intubation (ETT) – Oral-tracheal – Naso-tracheal Tracheostomy (trach) 1.
Trachea Mark Perna Sunday, May 02, 2010.
Tracheostomy Care Bill Wojciechowski, MS, RRT Department of Cardiorespiratory Care University of South Alabama Mobile, Alabama.
Respiratory Failure Kenney Weinmeister M.D.. Definition Demand overwhelms the capacity of the system Hypoxemia: PaO2 < 60 mmHg Hypercarbia: PaCO2 > 49.
1 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license.
TRACHEOSTOMIES AND PASSY- MUIR VALVES San Francisco General Hospital and Trauma Center Department of Speech-Pathology.
SVCC Respiratory Care Programs
Upper air way obstruction & Tracheotomy Dr. Lamia AlMaghrabi Consultant ENT King Saud Medical City.
Respiratory Specialist Physiotherapy
Stomas Ostomies and Home Ventilators By Wesley Rolfson.
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 36 Airway Management.
TRACHEOSTOMY CARE Rosie Ratcliffe (Previous Macmillan Head and Neck Clinical Nurse Specialist) Amended 2012.
Airway Management Part III
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