artificial airways n.
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  1. ARTIFICIAL AIRWAYS SVCC Respiratory Care Programs

  2. 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

  3. Types of Artificial Airways • Oropharyngeal airways • Nasopharyngeal tubes • Orotracheal tubes • Nasotracheal tubes • Tracheostomy tubes • Esophageal obturator airway • Cricothyroid tubes SVCC Respiratory Care Programs

  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 1. Pharyngeal reflex - 9th & 10th cranial nerves gag and swallowing SVCC Respiratory Care Programs

  5. 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

  6. 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

  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 SVCC Respiratory Care Programs

  8. 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

  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 SVCC Respiratory Care Programs

  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 SVCC Respiratory Care Programs

  11. 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

  12. 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

  13. 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

  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) SVCC Respiratory Care Programs

  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 SVCC Respiratory Care Programs

  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 SVCC Respiratory Care Programs

  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 SVCC Respiratory Care Programs