Artificial Airways

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Artificial Airways

• RET 2275L
• Respiratory Therapy Theory Lab 2
• Module 1.0

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Secretion Evacuation Devices

• Suction Regulator
• Provide a means of reducing the high negative
  pressures from the supply line to safe
  physiological levels

3
Secretion Evacuation Devices

• Suction Canisters
• Collection device
• Protects vacuum lines from infiltration of fluids
• Suction Tubing
• Connects regulator to canister, and canister to
  suction device (yankauer, suction catheter, etc.)

4
Secretion Evacuation Devices

• Yankauer Suction Tip
• AKA Tonsillar Tip
• Used to remove oral secretions

5
Secretion Evacuation Devices

• Suction Catheter
• Used to remove secretions from the lower airway

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Secretion Evacuation Devices

• Closed Suction System
• May reduce caregiver and patient risk of
  infectious disease exposure
• Permits the suction catheter to be used multiple
  times, reducing cost

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Secretion Evacuation Devices

• Lukens Trap
• Commonly referred to as sputum trap
• Used to obtain sputum specimens
• Placed in-line between the vacuum circuit and the
  suction catheter

Lukens trap closed after use
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Oropharyngeal Airways

• Function
• Restores airway patency by separating the tongue
  from the posterior wall of the pharynx
• Insertion
• Orally
• Use jaw lift or tongue displacement
• Correct sizing
• Measure from the corner of the patients mouth to
  angle of the jaw
• Incorrect placement can worsen obstruction!
• Used in comatose patients

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Oropharyngeal Airways
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Oropharyngeal Airways

• Insertion and placement of the oropharyngeal
  airway

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Nasopharyngeal Airways

• Function
• Restores airway patency by separating the tongue
  from the posterior wall of the pharynx
• Used when oral placement is not possible
• Insertion
• Nasally
• Necessary to check placement
• Correct sizing
• Measure from the patients earlobe to the tip of
  the nose
• Incorrect placement can worsen obstruction!
• Used in awake patients

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Nasopharyngeal Airways

• Proper placement of the nasopharyngeal airway

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Endotracheal Tubes

• Function
• Protect the airway
• Provide positive pressure ventilation
• Insertion Site
• Nasally
• Orally
• Placement
• In the trachea
• 2 3 cm above the carina

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Endotracheal Tubes

• Placement of the ET Tube

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Endotracheal Tubes
Standard adapter with a 15 mm external diameter
Radiopaque Strip (visible on x-ray)
Pilot tube
Body
Pilot balloon
Cuff
Beveled distal tip
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Endotracheal Tubes
Length makings (distance in cm from beveled tube
tip)
Z-79 or IT (Tissue toxicity testing)
Inner diameter
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Endotracheal Tubes

• Murphys eye
• Provides an alternate pathway for gas to flow in
  the event the distal tip become obstructed

Beveled distal tip
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Endotracheal Tubes

• Reinforced Wire-Wrapped ET Tube
• Helical reinforcing wire imbedded into the PVC
  material helps prevent kinking when used in a
  tortuous airway

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Double Lumen ET Tube

• Function
• Independent lung ventilation
• Unilateral lung disease
• Properties
• 2 proximal 15 mm ventilator connections
• 2 inner lumens for gas flow
• 2 cuffs
• Larger cuff seal trachea
• Smaller cuff seals bronchial lumen
• 2 distal openings
• Fiberoptic bronchoscopy needed to verify placement

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Double Lumen ET Tube

• Proper placement

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Combitube Airway

• Double lumen airway
• Esophageal gastric airway
• Endotracheal tube
• Effective whether in the esophagus or the trachea
• Designed to be inserted blindly
• Difficult intubation
• Short-term

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Combitube Airway

• Correct insertion and placement

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Laryngeal Mask Airway (LMA)

• Designed to form a low-pressure seal in the
  laryngeal inlet by means of an inflated cuff
• Maintains a patent upper airway and facilitates
  ventilation
• Designed to be inserter blindly
• Difficult intubation
• Short-term

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Laryngeal Mask Airway (LMA)

• Correct insertion and placement