Transcript Airway obstruction

Airway obstruction
Trauma



foreign bodies
inflammation
hematomas
CNS disease

secretions
Drug overdose
Infections

glottitis
Obstructive sleep apnea
Airway Protection
May be impaired for similar reasons
May decompensate with addition of
varied bolus sizes and consistencies
Artificial Airways
Rationale
upper airway obstruction
loss or impairment of airway protective
reflexes
inability to maintain clear airway
(secretions)
ventilator support
Maintaining a Patent Airway
Maintaining a clear airway
secretions
inability can have drastic effects
lung collapse
hypoxemia
laborious breathing
Skills needed for effective
clearing mechanism (cough)
deep breath
competent glottis
generate increased pressure
vital capacity of 15 cc/kg
Ventilator
Inability to maintain pulmonary function
Apnea
 Acute ventilator failure
 increased CO2 decreased pH

Hyperventilation
tracheostomy tube is required for
ventilator function
Disadvantages
Airway contamination
Diminished cough
Inability to vocalize
Loss of control
Increased difficulty swallowing
Types of Artificial Airways
Endotracheal tube
emergency
surgical
ICU
Cricothyroidotomy
emergency
Nasotracheal

nonpreferred method
oral cavity surgeries
Tracheostomy
long term intubation

greater than 10 - 21 days
Tracheostomy
Advantages
lower risk of laryngotracheal injury
improved comfort/mobility
improve airway stabilization
allows for oral nutrition
improved secretion clearance
Potential problems (24 hours)
pneumothorax
hemorrhage
subcutaneous emphysema
infection
tube displacement
Problems (long term)
aspiration
swallow dysfunction
increased incidence of RTI and pneumonia
tracheal stenosis a/o malacia
TE fistula
granulomas
obstruction
Tracheostomy tubes
Inner cannula
Outer cannula
Phalange
Obturator
Pilot balloon
Cuffs


high volume, low pressure
low volume, high pressure
Changing trach tube
malfunction
infection
more flexible
weaning
Suctioning
Complications
hypoxemia
 hypotension

slow heart rate
 prolonged coughing which slows rate

arrhythmia
lung collapse
mucosal damage
Trach tube types
Cuffed
Cuffless
Fenestrated
Communication tubes
Tracheal buttons