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

Transcript of Endotracheal Tube Suctioning - son.org.twson.org.tw/upload/Filedown/53.pdf · Endotracheal Tube...

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 <1000 gm premie

• +4 cm for 1000 – 2000 gm

• +5 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)

� <3mm preterm

� <4mm newborn

� Treatment varies depending on severity of lesion

� Tracheostomy for critical airway

�� From vocal cords to From vocal cords to cricoidcricoid cartilagecartilage

�� Definition: (diameter)Definition: (diameter)

�� <3mm preterm<3mm preterm

�� <4mm newborn<4mm newborn

�� Treatment varies Treatment varies depending on severity depending on severity of lesionof lesion

�� TracheostomyTracheostomy for for critical airwaycritical airway