endotracheal tube suctioning - son.org.twson.org.tw/upload/filedown/53.pdf · endotracheal tube...
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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
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EndotrachealEndotracheal Tube SuctioningTube Suctioning
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Endotracheal TubeSuctioning
Catheter size Suction length Frequency
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Endotracheal TubeSuctioning
Lubricate catheter with
sterile water or
saline if necessary
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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
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Endotracheal TubeSuctioning
Suction length (main bronchi):
ET tube length (inside + outside)
+3 cm for 2000 gm
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Endotracheal TubeSuctioning
Time:
As short as possible
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Endotracheal TubeSuctioning
Pressure:
-100 to -200 cmH2O
(-80 to -150 mmHg)
1mmHg = 1.36 cmH2O
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Endotracheal TubeSuctioning
Frequency:
Q 2-4 hr & prn
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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
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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:____________________________
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Chest Physical Therapy
Percussion
Vibration
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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
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photo from Colour Atlas of ENT Diagnosis; by T.R. Bull, p 197
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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
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SubglotticSubglottic stenosisstenosis
From vocal cords to cricoid cartilage
Definition: (diameter)