气 管 插 管 术PPT课件
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3.喉镜片抵达舌根与会厌交界处,上提喉 镜,撬起会厌,显露声门。advance the
laryngoscope until the epiglottis is in view.
17
操作步骤PROCEDURAL STEPS
4.右手以握笔式手势持气管导管,插过声 门,进入气管。lift the laryngoscope upward
0-3月(New born - 3 months ): ID 3.0 mm 3-9月 (3-9months) : ID 3.5 mm 9-18月( 9-18 months ): ID 4.0 mms 2- 6岁(2-6years): ID= (Age/3) + 3.5 > 6岁 ( > 6 years): ID = (Age/4) + 4.5
10
插管前准备Equipment preparation
❖插 管 深 度Depth of endotracheal tube 成人Adult 男性Male = 23 cms 女性Female = 21 cms 儿童Children 经口气管插管= (Age/2) + 12 (cm) 经鼻气管插管= (Age/2) + 15 (cm)
Care of critically ill patients with multi-system disease or injuries.
❖外科手术麻醉需要。
Control of the airway in surgical procedures requiring general anesthesia.
❖其 他 Other equipments
导丝Stylet 手套Gloves 吸痰器Suction Device 5ML注射器 syringe 固定器Endotracheal tube holder
14
操作步骤PROCEDURAL STEPS
1.仰卧,头垫高10cm,置入导管芯,将病人头部 尽量向后伸仰,使三轴线完全重叠,让插管径路 接近为一直线。 Position bed height to bring the patient's head to a mid-abdominal height.Flex the cervical spine and extend the head at the atlanto-occipital joint.Long axis of the oral cavity, pharynx, and trachea lie almost in a straight line.
3
呼吸道解剖Anatomy
气管插管的途径是 通过鼻腔或口腔, 经过咽喉、声门、 把插管插到气管 或总支气管内。
4
AN ATOM Y OF AIRW AY
5
适 应 症Indications ❖心跳、呼吸骤停。
Cardiac or respiratory arrest
❖丧失气道保护功能者。
Failure to protect the airway
15
16
2.左手持喉镜沿右口角置入口腔,左推舌 体,使喉镜移至正中位。Introduce the
blade into the right side of the patient's mouth, move the blade posteriorly and toward the midline, sweeping the tongue to the left and keeping it away from the visual path with the flange of the blade
8
插管前准备Equipment preparation ❖1.气管导管 导管的选择Size of endotracheal tube
按导管的内径计算 internal diameter (ID)
男性Male: ID 8.0 mms
女性Female : ID 7.5 mms
9
插管前准备Equipment preparation 儿童的导管选择Size of endotracheal tube
11
插管前准备Equipment preparation
❖2.喉 镜Laryngoscope
气管插管使用的为直 接喉镜。直接喉镜分 直镜(miller)和弯镜 (macintosh)两 种。
12插管前准备Equipmen Nhomakorabea preparation
❖操作前务必检查喉镜是否明亮
13
插管前准备Equipment preparation
气管插管术
新疆医科大学第一附属医院麻醉科 LOGO
Contents
1
定义及概述
2
适应症及禁忌症
3
操作
4
并发症
2
定 义Definition
气管插管术是一种将一特制的气管内 导管经声门置入气管的技术,这一技 术能为气道通畅、通气供氧、呼吸道 吸引和防止误吸提供 最佳条件。
The insertion of a tube into the trachea to allow air to enter the lungs.
❖严重呼吸衰竭不能满足机体通气和氧供需 要需机械通气者。
Inadequate oxygenation or ventilation
6
适 应 症Indications ❖即将发生或已发生的气道阻塞
Impending or existing airway obstruction
❖多系统疾病或损伤的护理需要。
7
禁忌症Contraindications
无绝对禁忌症,以下所列为相对禁忌症。
❖ 由于外部原因所致上气道梗阻Obstruction of the upper airway due to foreign objects
❖ 颈椎骨折Cervical fractures ❖ 食道疾病Esophageal disease ❖ 进食腐蚀性物质Ingestion of caustic substances ❖ 下颚骨折Mandibular fractures ❖ 喉头水肿Laryngeal edema ❖ 烫伤或化学药剂灼伤Thermal or chemical burns
laryngoscope until the epiglottis is in view.
17
操作步骤PROCEDURAL STEPS
4.右手以握笔式手势持气管导管,插过声 门,进入气管。lift the laryngoscope upward
0-3月(New born - 3 months ): ID 3.0 mm 3-9月 (3-9months) : ID 3.5 mm 9-18月( 9-18 months ): ID 4.0 mms 2- 6岁(2-6years): ID= (Age/3) + 3.5 > 6岁 ( > 6 years): ID = (Age/4) + 4.5
10
插管前准备Equipment preparation
❖插 管 深 度Depth of endotracheal tube 成人Adult 男性Male = 23 cms 女性Female = 21 cms 儿童Children 经口气管插管= (Age/2) + 12 (cm) 经鼻气管插管= (Age/2) + 15 (cm)
Care of critically ill patients with multi-system disease or injuries.
❖外科手术麻醉需要。
Control of the airway in surgical procedures requiring general anesthesia.
❖其 他 Other equipments
导丝Stylet 手套Gloves 吸痰器Suction Device 5ML注射器 syringe 固定器Endotracheal tube holder
14
操作步骤PROCEDURAL STEPS
1.仰卧,头垫高10cm,置入导管芯,将病人头部 尽量向后伸仰,使三轴线完全重叠,让插管径路 接近为一直线。 Position bed height to bring the patient's head to a mid-abdominal height.Flex the cervical spine and extend the head at the atlanto-occipital joint.Long axis of the oral cavity, pharynx, and trachea lie almost in a straight line.
3
呼吸道解剖Anatomy
气管插管的途径是 通过鼻腔或口腔, 经过咽喉、声门、 把插管插到气管 或总支气管内。
4
AN ATOM Y OF AIRW AY
5
适 应 症Indications ❖心跳、呼吸骤停。
Cardiac or respiratory arrest
❖丧失气道保护功能者。
Failure to protect the airway
15
16
2.左手持喉镜沿右口角置入口腔,左推舌 体,使喉镜移至正中位。Introduce the
blade into the right side of the patient's mouth, move the blade posteriorly and toward the midline, sweeping the tongue to the left and keeping it away from the visual path with the flange of the blade
8
插管前准备Equipment preparation ❖1.气管导管 导管的选择Size of endotracheal tube
按导管的内径计算 internal diameter (ID)
男性Male: ID 8.0 mms
女性Female : ID 7.5 mms
9
插管前准备Equipment preparation 儿童的导管选择Size of endotracheal tube
11
插管前准备Equipment preparation
❖2.喉 镜Laryngoscope
气管插管使用的为直 接喉镜。直接喉镜分 直镜(miller)和弯镜 (macintosh)两 种。
12插管前准备Equipmen Nhomakorabea preparation
❖操作前务必检查喉镜是否明亮
13
插管前准备Equipment preparation
气管插管术
新疆医科大学第一附属医院麻醉科 LOGO
Contents
1
定义及概述
2
适应症及禁忌症
3
操作
4
并发症
2
定 义Definition
气管插管术是一种将一特制的气管内 导管经声门置入气管的技术,这一技 术能为气道通畅、通气供氧、呼吸道 吸引和防止误吸提供 最佳条件。
The insertion of a tube into the trachea to allow air to enter the lungs.
❖严重呼吸衰竭不能满足机体通气和氧供需 要需机械通气者。
Inadequate oxygenation or ventilation
6
适 应 症Indications ❖即将发生或已发生的气道阻塞
Impending or existing airway obstruction
❖多系统疾病或损伤的护理需要。
7
禁忌症Contraindications
无绝对禁忌症,以下所列为相对禁忌症。
❖ 由于外部原因所致上气道梗阻Obstruction of the upper airway due to foreign objects
❖ 颈椎骨折Cervical fractures ❖ 食道疾病Esophageal disease ❖ 进食腐蚀性物质Ingestion of caustic substances ❖ 下颚骨折Mandibular fractures ❖ 喉头水肿Laryngeal edema ❖ 烫伤或化学药剂灼伤Thermal or chemical burns