Tracheal Suction - Complications
- Hypoxia during the procedure leading to cardiac arrhythmias and fits.
- Aggravation of acute pulmonary oedema by increasing the amount of transudation of oedemal fluid.
- Trauma to the tracheo-bronchial mucosa.
Endotracheal Intubation – (ETT) sizes
6 years
5.5mm uncuffed
Formula (age÷4) +4
Endotracheal Intubation – (ETT) sizes
6 months
3.5mm uncuffed
Formula (age÷4) +4
Intragastric Tube
Contraindications
With suspected fractured base of skull and facial injuries, the tube must be inserted through the mouth and not the nose.
Intragastric Tube
Sizes
Adults - 14FG
Children - 12FG
Neonates - 10FG
Endotracheal Intubation – (ETT) sizes
Larger Males
9mm cuffed
Endotracheal Intubation – (ETT) sizes
10 years
6mm cuffed
Formula (age÷4) +4
Tracheal Suction - catheter Size
Tube 5mm
8FG
Intragastric Tube
Indication
Gastric distension with air or fluid eg near drowning or poorly performed EAR which can cause:
- Increased risk of regurgitation.
- Fluid absorption and consequent fluid overload.
- Interference with breathing or IPPV especially in children.
- All intubated children to receive IPPV.
- Continuous vomiting.
- Transport of neonates, spinal injuries, abdominal problems - especially by air.
I I F A C T
Tracheal Suction - catheter Size
Tube 4mm
6FG
Tracheal Suction - catheter Size
Tube 3mm
6FG
Tracheal Suction - catheter Size
Tube 7mm
12FG
Endotracheal Intubation – (ETT) sizes
Neonate
3mm uncuffed
Formula (age÷4) +4
Tracheal Suction - catheter Size
Tube 3.5mm
6FG
Tracheal Suction - Contraindications
- Tracheal suction should not be used in a patient with acute pulmonary oedema who has copious secretions of a watery consistency. These secretions can be clear, yellow or pink in colour.
- Never put a Yankauer sucker into an endotracheal tube.
Endotracheal Intubation – (ETT) sizes
12 years
7mm cuffed
Formula (age÷4) +4
Endotracheal Intubation – (ETT) sizes
Females or small males
8mm cuffed
Tracheal Suction - catheter Size
Tube 6mm
10FG
Tracheal Suction - Indication
To remove secretions or blood from the tracheo-bronchial tree.
Endotracheal Intubation – (ETT) sizes
8 years
6mm cuffed
Formula (age÷4) +4
- Endotracheal Intubation – Complications
DOTI
- Dislodgement/ Malposition into oesophagus,
oro-pharynx or right main bronchus
- Tie tube in firmly
- Look and listen over epigastrium to exclude gastric distension and oesophageal intubation
- Monitor end tidal CO2
- Endobronchial, usually the right, make sure both sides of chest are being inflated by monitoring chest rise and auscultating both axillae
- Inflation of cuff too high/ between vocal cords, causes great pain, laryngeal damage and increases potential dislodgement. Ensure cuff is positioned below larynx
- Obstruction
- Mucous or blood blocking lumen
- Kinking in pharynx
- External pressure from biting
- Herniation of cuff
- Impingement of bevel on the carina or side wall of trachea
- Trauma
- Lips
- Teeth
- Toung
- Pharynx
- Larynx and trachea
- Cervical cord injury with spinal fractures
- Interference with physiological functions
- Filtering
- Warming
- Humidifying
- Talking
- Coughing
- Straining
- Swallowing
Endotracheal Intubation – (ETT) sizes
1 year
4mm uncuffed
Formula (age÷4) +4
Endotracheal Intubation – (ETT) sizes
2 years
4.5mm uncuffed
Formula (age÷4) +4
Tracheal Suction - catheter Size
Tube 8 & 9mm
14FG
