Anesthesiology Instruments

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Anesthesiology instruments


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1. Airway equipment

To ensure the patient has a patent airway

Prevent the tongue from falling back and

hence blocking the airway


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Oropharyngeal airway

Known as Guedel airway

Curved plastic tubes

Lie over the tongue preventing it from falling back into the pharynxCommon sizes 2-4

Estimated by comparing the airway length with the vertical distance

between the patient's incisor teeth and the angle of the jaw.


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Nasopharyngeal airway

Round malleable plastic tube

Beveled at the pharyngeal end

Flanged at the nasal end

Lie along the floor of the noseCurve round into the pharynx

Common sizes : 6-8mm diameter

Estimated by comparing the airway length with the vertical distance

between the patient's anterior nares of the nose to the tragus of the ear.


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Laryngeal Mask Airway (LMA)

Sits over the laryngeal opening

Attached to a tube that protrudes from the mouth

Connects directly to the anesthetic breathing systemInflatable cuff to stabalise and create a seal

Common sizes are 3-5

Designed for spontaneously breathing patients

It is also possible to ventilate patients with the LMA


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LMA fastrach

Modified laryngeal mask specifically

Designed to allow tracheal intubation while maintaining ventilationin patients with either normal or abnormal airways.

The chief features of the design are an anatomically curved, rigid,

metallic conduit with an integral handle, an epiglottic elevating bar,

and a guiding ramp designed to direct an endotracheal tube

anteriorly into the glottis as it exits from the device


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Proseal LMA

Supraglottic airway deviceAdditional posterior cuff to

improve the seal between the

mask and the larynx

Incorporates a gastric drainage

tube placed lateral to the main

airway tube and which ends at

the tip of the mask

Ryles tube can be inserted to

aspirate gastric contents


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Tracheal tubes

A catheter inserted into the airway

For the primary purpose of establishing and maintaining a

patent airway and to ensure the adequate exchange of oxygen

and carbon dioxide

2 different types : ETT and tracheostomy tube

Endotracheal tube, cuffed Tracheostomy tube, cuffed


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Standard PVC Preformed tube :

Used during surgery of head and neck

Designed to take the connections away

from the surgical field.


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Ring-Adair-Elwin (RAE) tube

Allows the endotracheal tube, once

placed, to be angled away from the face

to facilitate access during surgeriesaround the head and neck


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Double lumen :

2 tubes effectively wielded side by side

One tube extending distally beyond the

other

Used during thoracic surgery allowingone lung to be deflated whilst

ventilation is maintained via the

bronchial portion of the opposite lung.

Reinforced tube :

Prevent kinking and subsequent

obstruction

When positioning the patients head


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Laryngoscope

Curved bladeMcCoys blade

Enable direct visualization of the larynx

To facilitate the insertion of the tracheal tube

Light at

the tip

Handle that

contains

batteries


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Gum elastic bougie

60 cm long malleable introducer

Adjunct for difficult endotracheal intubation

Flexible but has some shape retention

Slightly angled tip

Indication:For directional control during routine or difficult endotracheal intubation

when the laryngeal inlet cannot be completely seen.

Precaution:

Excessive force, passage beyond the carina, or blind introduction may result

in soft tissue damage or may cause rupture of the bronchus.


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2. Facemasks


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3. Anesthetic gases


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Oxygen

Gas cylinder has : white shoulder ; black body


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Nitrous oxide

Gas cylinder has : blue shoulder ; blue body


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Medical air

Air is supplied to the operating theatre at :

- 400kPa for anesthetic use

- 700kPa to power medical tools

Air cylinder has : white/black shoulder ; grey body


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Vacuum


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3. The anesthetic machine


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Flow meter

Main functions are :-Reduce the high pressure gases

from either pipeline or cylinder

-Control the flow of gases allowing a

known and adjustable compositionto be delivered into the anesthetic

breathing system

The needle valve controls the flow

through a flow meter


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Anesthetic breathing circuit


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Gases from the anesthetic machine

Mixture of anesthetic gases and vapour

Anestheticcircuit

Face mask/

Laryngeal mask/

Tracheal tube

Patients lungs


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Circle breathing system

Components for a breathing system:

-Connection for fresh gas input

-Reservoir bag

-Adjustable expiratory valve

(Soda lime)


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Anesthesiology Instruments

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