Endotracheal Tube Suctioning - son.org.twson.org.tw/upload/Filedown/53.pdf · Endotracheal Tube...
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
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
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:____________________________
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
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