Transcript ARTIFICIAL AIRWAYS

ARTIFICIAL AIRWAYS
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
SVCC Respiratory Care Programs
Types of Artificial Airways
Oropharyngeal airways
 Nasopharyngeal tubes
 Orotracheal tubes
 Nasotracheal tubes
 Tracheostomy tubes
 Esophageal obturator airway
 Cricothyroid tubes

SVCC Respiratory Care Programs
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
1. Pharyngeal reflex
- 9th & 10th cranial nerves
gag and swallowing
SVCC Respiratory Care Programs
Indications (cont’d)

Reflexes (cont’d)
2.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
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
SVCC Respiratory Care Programs
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

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
SVCC Respiratory Care Programs
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

SVCC Respiratory Care Programs
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
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

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

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%

SVCC Respiratory Care Programs
Complications and Hazards of
Tracheostomies
Postsurgical bleeding
 Infection
 Mediastinal emphysema
 Pneumothorax
 Subcutaneous emphysema
 Stoma collapse (should not be moved
or changed first 36 hours)

SVCC Respiratory Care Programs
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
SVCC Respiratory Care Programs
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

SVCC Respiratory Care Programs
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
SVCC Respiratory Care Programs