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26 Cards in this Set
- Front
- Back
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#1 cause of morbidity and mortality in human anesthesia
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-failed intubation
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Intubation
-indications for use |
-maintain patent airway
-prevent aspiration of foreign material -application of assisted ventilation (positive pressure ventilation) -dependable delivery of anesthetic gases and oxygen |
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Intubation
-required equipment |
-appropriate endotracheal tubes
-laryngoscope/light source -gauze tie -cuff inflation syringe -lubricant |
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Intubation
-typical size of the cuff inflation syringe for small animals |
-12cc
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Intubation
-lubricants used |
-KY Jelly
-water |
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Laryngoscope
-requirements |
-appropriate blade
-bright and tight light |
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Laryngoscope
-reasons why light may not be bright |
-foreign material
-dying batteries |
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Laryngoscope
-when choosing blades, what should you go for |
-larger blade
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Custom designed laryngoscopes are used for _____
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-small ruminants
-calves -alpacas/llamas -etc. |
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Endotracheal tubes
-standard adult cat size |
-4.5
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Endotracheal tube
-parts |
-15mm connector
-tube size measured by internal diameter -varied cuff styles -pilot balloon with luer slip adaptor |
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Endotracheal tube
-where should the cuff be placed |
-about mid-cervical
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Endotracheal tube
-cuff types |
-high volume, low pressure
-silicone |
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Endotracheal tubes
-reasons to make sure the cuff doesn't leak |
-can't preform positive pressure ventilation if needed
-anesthetic leak into room |
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Endotracheal tube
-basic technique |
-sternal recumbency
-extend head and open mouth -insert laryngoscope and visualize airway opening by depressing epiglottis (must visualize) -local anesthetic application in cats (spray lidocaine) -pass tube through airway opening -secure tube and inflate cuff |
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Endotracheal tube placement
-where should the laryngoscope tip be in relation to the epiglottis |
-under the tip to prevent trauma to the epiglottis
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Evidence of proper endotracheal placement
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-visualize the tube passing through the airway opening
-air movement through tube corresponding with breathing efforts (Listen and Feel Flow) --> esophageal stethoscope -condensation of moisture on interior of tube during exhalation -no vocalization -carbon dioxide detection in expired air |
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Endotracheal tube
-why is there condensation of moisture in the tube |
-exhaled air is humidified
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Testing cuff inflation
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-close pop-off valve
-squeeze rebreathing bag to exert airway pressure Cuff seal @ 15cm H2O Cuff leak @ 20 cm H2O |
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Why is cuff leakage at 20 cmH2O important?
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-prevention of tracheal necrosis
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Hodgson's Cuff Inflation Technique
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-intubate and secure endotracheal tube
-place esophageal stethoscope at laryngeal opening and place earpiece in ears -attach syringe to pilot balloon luer adaptor -inflate cuff to know it is sealed -hold cuff syringe in 1 hand to be able to withdraw air -close pop-off and squeeze rebreathing bag with alternate hand until pressure of 20cm H20 is seen on manometer -withdraw air from pilot balloon until slight leak detected -relax rebreathing bag compression to reduce pressure to 15cm H2O on manometer -if no leak, then done -remove syringe from pilot balloon -open pop-off valve -if slight leak at 15cm H2O add some air and recheck at 20cm H2O |
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Alternative intubation techniques
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-Digital palpation (large ruminants, elephants)
-Blind intubation (horse, rabbit) -Nasotracheal intubation (horses, etc.) -Use of a guide tube |
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Alternate intubation aids
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-rigid stylets
-flexible tube guides -specialty laryngoscopes -lidocaine spray |
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Alpaca intubation
-first step |
-rinse foreign material out of mouth
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Alpaca intubation
-why remain in sternal recumbency |
-prevent passive regurgitation
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Alpaca intubation
-method of securing endotracheal tube |
-tape wing
-secure to cheek |
