Healthcare and Medicine Reference
In-Depth Information
Hyoid bone
Epiglottis
T
hyrohyoid
membrane
Thyroid
cartilage
Cricothyroid
muscles
Cricothyroid
ligament
Cricoid
cartilage
Trachea
Figure 15.2 Structure of the larynx.
Figure 15.4 A typical curved blade laryngoscope.
Trachea
Right main bronchus
Left main bronchus
Lobar bronchus
Segmental bronchi
Figure 15.3 Trachea and its bifurcation into left and right main bronchi:
the right main bronchus is wider and more vertical than the left. It is
therefore more prone to being intubated if an endotracheal tube is
advanced too far.
Cuffed tracheal tubes
Tubes used for intubation are single use and usually made of PVC.
The internal diameter is marked on the outside of the tube in
millimetres.
The tube is cut down to size to suit the individual patient, the
length being marked on the outside in centimetres.
Cuffed tracheal tubes are used in adults. When infl ated, the cuff
forms a tight seal between the tube and tracheal wall. It protects the
patient's airway against aspiration. The cuff is connected to a pilot
balloon at the proximal end of the tube. After intubation the cuff is
infl ated via the pilot balloon until no gas leak can be heard during
ventilation (Figure 15.5).
Figure 15.5 A typical PVC endotracheal tube. Current advanced life
support guidelines recommend the use of a size 8.0 mm internal
diameter tube in an adult male and a size 7.0 mm tube in an adult female.
However, a range of tube sizes should be available appropriate to the
size of the patient.
Additional equipment
In addition to the equipment mentioned above, adjuncts to
intubation especially with diffi cult or potentially diffi cult airways
are commonly used. This equipment includes the gum elastic
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