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  • Endotracheal Tube

    Suctioning

    Et tube, a foreign body in trachea, causes irritation and increase production of secretions

    Suppress ciliar motion Diminishes the ability to cough and mobilize

    secretions

    Suctioning is a must

  • EndotrachealEndotracheal Tube SuctioningTube Suctioning

  • Endotracheal TubeSuctioning

    Catheter size Suction length Frequency

  • Endotracheal TubeSuctioning

    Lubricate catheter with

    sterile water or

    saline if necessary

  • Endotracheal TubeSuctioning

    Catheter size:

    6.5 Fr. for 2.5 mm I.D. ET tube 8.0 Fr. for 3.0 & 3.5 I.D. ET tube

  • Endotracheal TubeSuctioning

    Suction length (main bronchi):

    ET tube length (inside + outside)

    +3 cm for 2000 gm

  • Endotracheal TubeSuctioning

    Time:

    As short as possible

  • Endotracheal TubeSuctioning

    Pressure:

    -100 to -200 cmH2O

    (-80 to -150 mmHg)

    1mmHg = 1.36 cmH2O

  • Endotracheal TubeSuctioning

    Frequency:

    Q 2-4 hr & prn

  • Endotracheal TubeSuctioning

    Head position:

    Turn to left side for suction of right main stem bronchus

    Turn to right side for suction of left main stem bronchus

  • Name:___________________________

    Length(C-H):_____________________

    Depth of suction: __ cm. = NTT length

    (__cm. Inside + __cm. Outside) + 3 to

    5cm. (3 cm for 1000 gm premie and 5

    cm. for term infant)

    NTT size:________________________

    Nurse signature:___________________

    Date:____________________________

  • Chest Physical Therapy

    Percussion

    Vibration

  • Problems of Airway (short list)Problems of Airway (short list)

    Laryngeal web

    Subglottic stenosis

    Hemangioma

    Vascular anomalies (rings/slings)

    Tracheal stenosis

    Complete tracheal rings

    Laryngeal webLaryngeal web

    SubglotticSubglottic stenosisstenosis

    HemangiomaHemangioma

    Vascular anomalies (rings/slings)Vascular anomalies (rings/slings)

    Tracheal Tracheal stenosisstenosis

    Complete tracheal ringsComplete tracheal rings

  • photo from Colour Atlas of ENT Diagnosis; by T.R. Bull, p 197

  • Laryngeal webLaryngeal web

    Congenital lesion

    Incomplete epithelial reabsorption larynx (week 8)

    75% glottic level involving vocal cords

    Abnormal cry, stridor, respiratory distress

    Small webs rarely require treatment

    Large, symptomatic ones removed by endoscopic laser/knife

    Congenital lesionCongenital lesion

    Incomplete epithelial Incomplete epithelial reabsorptionreabsorption larynx larynx (week 8)(week 8)

    75% 75% glotticglottic level level involving vocal cordsinvolving vocal cords

    Abnormal cry, Abnormal cry, stridorstridor, , respiratory distressrespiratory distress

    Small webs rarely Small webs rarely require treatmentrequire treatment

    Large, symptomatic Large, symptomatic ones removed by ones removed by endoscopic laser/knifeendoscopic laser/knife

  • SubglotticSubglottic stenosisstenosis

    From vocal cords to cricoid cartilage

    Definition: (diameter)

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