Tue, 12 Jun 2012|
Mike McEvoy shares some tips on clearing an obstructed airway in a patient.
[MUSIC] Hi, welcome to training minutes. Today I'm gonna talk about managing an obstructed airway with some techniques that you can use for the endotrachial tube that you've placed in a patient and are not able to ventilate them. We have a suction machine here that we would ordinarily use. Now if you're trying to clear an airway, you probably use a rigid suction tip like this Yankauer suction tip. At times, you're gonna end up intubating a patient with an endotracheal tube. And you'd wish, at times, that you could suction through the endotracheal tube to try to pull aspirate out of a patient. But let's say that. You've placed an endotracheal tube and you're unable to ventilate the patient. We could attach to this tube a meconium aspirator similar to the device that you use with neonates when they're born and you connect this to the suction unit and then connect it to the endotracheal tube to clear the lungs of the infant out. And in this instance, we'll take this meconium aspirator, and use it, with the adult endotracheal tube, to remove a foreign body, from the airway or from the lungs. The difficulty, with, a adult endotracheal tube, or any cuffed tube for that matter, is the eyelet, on the bottom of the tube. And the fact that the tube itself is beveled and so, the design of the tube is such that if you were to apply vacuum to it, the lung, or the airway would separate from the side of the tube through the beveling, or through the outlet on the side of the tube. So in order to apply suction to this device. What's going to be necessary to do, is first to have an adapter, such as this meconium asperating adapter, that fits over the end of the endotrachial tube, and then to eliminate the end of the tube that has the pieces that would lose the vacuum. And so what would do with the tube. It's cut the endo tracheal tube at the end, so that now we've eliminated everything that would lose suction on the end of the tube. Connect the tube to your suction unit, we';ll turn the suction unit on and when you apply. Covering over the hole of the aspirator, you'll actually get vacuum through the endotracheal tube itself. So, if you place a tube in a patient and you're unable to ventilate, you suspect that there's a foreign body in the airway and you cannot get the body out by visualization, using forceps, or conventional techniques. Prior to doing a very sophisticated procedure like a trach, you may consider hooking a meconium aspirator up to your endotracheal tube, cutting the end of the tube off, and applying vacuum to remove the foreign body from the airway, with the endotracheal tube attached to your suction unit in that fashion. It's an excellent technique, has been described in the medical literature several times, and is a great way to eliminate a foreign body in a patient's airway that's causing an obstruction to your ability to ventilate them. I'm Mike Macavoidy, MS Editor for fire engineering, thanks for watching training minutes.