Airways and Tube ( Dr. Samrth Pareta )ppt.pptx

Surgical airways and tube used in hospitals for maintenance of open airway.

1. Topic - Airways and Tubes – Samrth Pareta

2. Introduction Causes Types Sign and Symptoms Contraindications Complications Content

3. To help maintain an open airway in patients who are unable to breathe effectively on their own because of any circumstances the tubes or surgical airways is used. If no spontaneous respiration occurs after airway opening and no respiratory devices are available, rescue breathing (mouth-to-mask or mouth-to-barrier device) is started; mouth-to-mouth ventilation is rarely recommended. Exhaled air contains 16 to 18% oxygen and 4 to 5% carbon dioxide. (2) Introduction

4. The number one priority is always the airway. A surgical airway should be considered when endotracheal intubation is not an option or fails. In the past, the primary reason for the placement of a surgical airway was emergent due to an impending airway obstruction, inability to intubate, or inability to ventilate. (1) Introduction Cont…

5. Inhaling or swallowing a foreign object Small object lodged in the nose or mouth Allergic reaction Trauma to the airway from an accident Vocal cord issues Breathing in a large amount of smoke from fire Viral infections Causes of Airways Obstruction

6. Bacterial infections Respiratory illness that causes upper airway inflammation Swelling of the tongue or epiglottis Abscesses in the throat or tonsils Asthma Emphysema Cystic fibrosis Causes Cont…

7. Oropharyngeal Airway - An oropharyngeal airway (oral airway, OPA) is an airway adjunct used to maintain or open the airway by stopping the tongue from covering the epiglottis. In this position, the tongue may prevent an individual from breathing. This sometimes happens when a person becomes unconscious because the muscles in the jaw relax causing the tongue to obstruct the airway.(5) Types of Tubes

8. Made of hard plastic/rubber, used in post anaesthesia / unconscious patient because of gag reflex Effective for blocking bite : seizures Ensure connect size : placed against side of mouth , opening at lips , tip end at angle of mandible Short term solution Oropharyngeal Cont…

9. A nasopharyngeal airway device (NPA) is a hollow plastic or soft rubber tubes that can utilize to assist with patient oxygenation and ventilation in patients who are difficult to oxygenate or ventilate .NPAs are passed into the nose and through to the posterior pharynx. NPAs do not cause patients to gag and are, therefore, the best airway adjunct in an awake patient and a better choice in a semiconscious patient (6) Nasopharyngeal Airway Device

10. Laryngeal mask airways (LMA) are supraglottic airway devices. They may be used as a temporary method to maintain an open airway during the administration of anesthesia or as an immediate life-saving measure in a patient with a difficult or failed these are single-use or reusable supraglottic airway, are designed to be inserted blindly through the mouth and into the hypopharynx to seal around the glottic opening allowing for ventilation. (7) Laryngeal Mask Airway

11. This is an extraglottic device which is positioned inferior to but outside the glottis.The esophageal tracheal airway or Combitube is a double-lumen tube with two cuffs which has been around since 1987. It is supplied with two syringes which are already primed right out of the box to the correct inflation volume for each cuff of 12 ml and 85 ml respectively. Each lumen of the Combitube can be connected to a breathing system via a standard 15 mm tube connector and color-coded port. Esophageal Tracheal Airway

12. The shorter white port is for the distal lumen, which opens just to the side of the atraumatic bevelled tip of the tube. The longer blue port is for the proximal lumen, which opens between the two cuff through eight side holes. The esophageal tracheal airway is available in two sizes. This device is not suited for use in pediatric patients. Esophageal Tracheal Airway Cont…

13. The endotracheal tube (ETT) was first reliably used in the early 1900s. In its simplest form, it is a tube constructed of polyvinyl chloride (PVC) that is placed between the vocal cords through the trachea to provide oxygen and inhaled gases to the lungs. It also serves to protect the lungs from contamination, such as gastric contents and blood.(8) Endotracheal Tube

14. The Tube The ETT is measured from the distal end of the tube and is typically marked in 2 cm increments. After successfully intubating the patient, the depth of the endotracheal tube ending at the teeth or lips should be noted. This depth provides a baseline measurement to ensure the tube has not traveled out of the trachea or deeper into the trachea with patient movement or transport. Endotracheal Tube Cont…

15. The Cuff A cuff is an inflatable balloon at the distal end of the ETT. The inflated cuff produces a seal against the tracheal wall; this prevents gastric contents from entering the trachea. The cuff inflates by attaching an appropriate size syringe to the pilot balloon. The syringe provides air under pressure and inflates both the pilot balloon and the cuff. Once the cuff inflates, the syringe must be removed. Endotracheal Tube Cont…

16. The Bevel The ETT has an angle or slant known as a bevel to facilitate placement through the vocal cords and to provide improved visualization ahead of the tip The Murphy's Eye This is a built-in safety mechanism at the distal tip, which is another opening in the tube positioned in the distal lateral wall. This prevents complete obstruction of the tube. Endotracheal Tube Cont…

17. Tracheostomy is a hole that surgeons make through the front of the neck and into the windpipe (trachea). A tracheostomy tube is placed into the hole to keep it open for breathing. A tracheostomy provides an air passage to help you breathe when the usual route for breathing is somehow blocked or reduced. A tracheostomy is often needed when health problems require long-term use of a machine (ventilator) to help you breathe. Tracheostomy Tube

18. agitation cyanosis (bluish-colored skin) confusion alterations in normal breathing pattern, whether rapid or shallow breathing difficulty breathing or no breathing gasping for air Sign and Symptoms of Airway Obstruction

19. Sign and Symptoms Cont… panic high-pitched breathing noises called which may sound like wheezing decreased breathing sounds in the lungs cardio-respiratory arrest unconsciousness

20. Absolute Contraindications: Facial Trauma Base of Skull Fracture : contraindicated due to the risk of exacerbating the injury. Severe Upper Airway Obstruction : In some cases, the presence of a foreign body or severe upper airway obstruction may complicate the use of certain airway devices. Contraindication

21. Relative Contraindications: Cervical Spine Injury : Special techniques and precautions may be needed to minimize movement during airway management. Coagulopathy : Patients with bleeding disorders or those on anticoagulant medications Anatomical Abnormalities Unstable Cardiovascular Status : In critically ill patients with unstable cardiovascular conditions. Contraindication Cont…

22. Complications : Infection Trauma : Improper insertion or manipulation of airway tubes may cause trauma to surrounding structures Aspiration : During intubation, there is a risk of aspirating stomach contents into the lungs Tube Displacement : Airway tubes may become dislodged, leading to inadequate ventilation or oxygenation. Complications

23. Patel SA, Meyer TK. Surgical airway. Int J Crit Illn Inj Sci. 2014 Jan;4(1):71-6. doi: 10.4103/2229-5151.128016. PMID: 24741501; PMCID: PMC3982374. https://www.ncbi.nlm.nih.gov/books/NBK470403/ https://doi.org/10.1016/j.resuscitation.2009.11.007 https://www.msdmanuals.com/en-in/professional/critical-care-medicine/respiratory-arrest/tracheal-intubation https://www.ncbi.nlm.nih.gov/books/NBK470198/ https://www.ncbi.nlm.nih.gov/books/NBK513220/ https://www.ncbi.nlm.nih.gov/books/NBK482184/ https://www.ncbi.nlm.nih.gov/books/NBK539747/#:~:text=The%20endotracheal%20tube%20(ETT)%20was,inhaled%20gases%20to%20the%20lungs. References

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