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An Endotracheal tube is a device inserted into the patient's trachea through the mouth or nose to maintain an open airway.
It is used to assist the delivery of anaesthetic gases or air to and from the patient. Control of the airway with Endotracheal tube is usually regarded as the 'Gold Standard' (C McCartney and D.J. Wilkinson, Current Anaesthesia and Critical Care 1995).
Tracheal Intubation Objectives
1 Guarantee patency of the upper airway.
2 Protect the airway from gastrict contents.
3 Allow mechanical positive pressure management.
4 Permits tracheobronchial suction.
Anatomy and Physiology of the Respiratory System
The respiratory system can be broadly defined into the upper respiratory tract and the lower respiratory tract. The organs of the system include the nasal cavities, the pharynx, the larynx, the trachea, the bronchi and their smaller branches and the lungs which contain the terminal air sacs or alveoli.
Air inhaled through the nasal cavity is filtered by cilia. The air is also warmed and moistened by the capillary blood supply to the mucosa of the upper respiratory tract. The air then goes into the pharynx, larynx and followed by the trachea. The trachea stretches and descends during inspiration and recoils during expiration. The cartilage rings prevent it from collapsing and maintaining patency during breathing.
Air enters the right and left bronchus before reaching the bronchioles and later the alveoli, which contain capillaries where the gaseous exchange takes places. To ensure that the lungs are being ventilated at all times and protect against potential blockages by the tip of the tube resting on the trachael wall, all Flexicare Endotracheal Tubes have a Murphy Eye as standard. The Murphy Eye also helps to maintain flow during suctioning, and also aids in maintaining the flow of the gases to both lungs should the tube move further into one of the bronchuses.
It is used to assist the delivery of anaesthetic gases or air to and from the patient. Control of the airway with Endotracheal tube is usually regarded as the 'Gold Standard' (C McCartney and D.J. Wilkinson, Current Anaesthesia and Critical Care 1995).
Tracheal Intubation Objectives
1 Guarantee patency of the upper airway.
2 Protect the airway from gastrict contents.
3 Allow mechanical positive pressure management.
4 Permits tracheobronchial suction.
Anatomy and Physiology of the Respiratory System
The respiratory system can be broadly defined into the upper respiratory tract and the lower respiratory tract. The organs of the system include the nasal cavities, the pharynx, the larynx, the trachea, the bronchi and their smaller branches and the lungs which contain the terminal air sacs or alveoli.
Air inhaled through the nasal cavity is filtered by cilia. The air is also warmed and moistened by the capillary blood supply to the mucosa of the upper respiratory tract. The air then goes into the pharynx, larynx and followed by the trachea. The trachea stretches and descends during inspiration and recoils during expiration. The cartilage rings prevent it from collapsing and maintaining patency during breathing.
Air enters the right and left bronchus before reaching the bronchioles and later the alveoli, which contain capillaries where the gaseous exchange takes places. To ensure that the lungs are being ventilated at all times and protect against potential blockages by the tip of the tube resting on the trachael wall, all Flexicare Endotracheal Tubes have a Murphy Eye as standard. The Murphy Eye also helps to maintain flow during suctioning, and also aids in maintaining the flow of the gases to both lungs should the tube move further into one of the bronchuses.
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Endotracheal Tubes - Introduction
Flexicare offer endotracheal tubes with two different cuff types:
Standard low Pressure Cuffs
VentiSeal High Volume Low Pressure Cuffs
The graph demonstrates the difference between the two types of Endotracheal tubes in relation to cuff pressure and cuff volume. The pressure necessary for the Standard Cuff to form an adequate seal increases as cuff volume increases. This happens at a higher ratio than compared with the Endosoft HVLP cuff. This characteristic determines the term of use of the respective cuffed endotracheal tubes.
Standard low Pressure Cuffs
VentiSeal High Volume Low Pressure Cuffs
The graph demonstrates the difference between the two types of Endotracheal tubes in relation to cuff pressure and cuff volume. The pressure necessary for the Standard Cuff to form an adequate seal increases as cuff volume increases. This happens at a higher ratio than compared with the Endosoft HVLP cuff. This characteristic determines the term of use of the respective cuffed endotracheal tubes.
The Standard Low Pressure Endotracheal Tubes are ideal for short-term intubation while the Endosoft HVLP cuff is designed for longer term anaesthesia where cuff forms a seal without putting excess pressure on the wall of the trachea. Over inflation of a Standard Cuff and prolonged use will occlude the capillaries in the tracheal wall and will cause necrosis as shown in Figure 2.
The Murphy Eye is standard on all Venticaire Endotracheal Tubes to ensure that adequate ventilation is maintained even if the tip of the Tube was fixed to the tracheal wall or occluded by secretions.
The Murphy Eye is standard on all Venticaire Endotracheal Tubes to ensure that adequate ventilation is maintained even if the tip of the Tube was fixed to the tracheal wall or occluded by secretions.
Figure 2
Figure 3