1

2

3

1) For supporting ventilation in pa tient with some pathologic disea

se : U pper airway obstruction

: Respi rat ory failure : L oss of con

ciousness

4

For supporting ventilation during general anesthesia

Type of surgery

: Operative site near the airway

: Abdominal or tho racic surgery

5

: Prone or lateral position

: Long period of surgery

Patient has risk of p ulmonary aspiration Difficult mask ventilation

6

ANATOMY OF AIRWAY

7

--- : Congenital anomalies > Pier re Robin syndrome , Down’s sy

ndrome -- : Infection in airway > Retroph

aryngeal abscess, Epiglottitis : Tumor in oral cavity or larynx

1 ) Condition that associate d with difficult intubation

8

- 2) Interincisor gap : normal > more th 3an cms

9

3) Mallampati classification: Clas - 34s , > may be difficult intubat

iii Soft pa

lateUvula

10

- 34grade , > risk for difiiiiii iiiiiiiiii

Laryngoscopic view

11

4) : 6Thyromental distance more than cii

12

5) Flexion and extension of neck

13

iiiiiiiiiiiiiiiii iiiii iiiii 6) ()

14

1) Laryngoscope : handle and blade

15

Macintosh (curved) and Miller (straight ) blade

Adult : Macintosh blade, small children : Miller blade

Miller blade Macintosh blade16

2 ) Endotracheal tube

17

80 7Male: ID . mms . Female : ID . 5 mms

- ii i ii i i3 : 3 . 0i

- 3 9 : 3 .5months ID mmi

- 918 40months : ID . mii

- ii i 2 6 : = (/3) +3 .5

ii i > 6 : = (4Age/ ) 45+ .

1) Size of endotracheal tube : internal diameter (ID)

18

3) Endotracheal tube cuff

High volume Low pressure cuff

Low volume High pressure cuff

2) Material : Red rubber or PVC

19

4) Bevel iii5) ’

20

6 ) Depth of endotracheal tube : Mid 2trachea or below vocal cord ~

cms - ii i iiii iii > = 2 3 ,

21= cms iiiiiiii

iiii iiiiiiiiiiii iiii = ( 2Age/

i 12+ (cm) iiiiiiiiiiii iiii i = (2Age/ )

15+ (cm)

21

7 ) Tube markings

-79Ziiiiiiiiii iii iii iiiiii Oral/Nasal Radi opaque marker

22

31. Stylii

23

3.2 Oropharyngeal or nasopharyngeal airway

Oral airway Nasal airway

24

33. ) Suction catheter 34. ) Slip joint

25

3.5)Face mask andsel f i nfl at i ngbag

36. ) Magill forcep

26

37. ) Syringe 38. ) Lubricating jelly 39. ) Plaster for strap endot

iiiiiii iiii 4. Monitoring success of

iiiiiiiiiiii iiiiiiiiii

4.1) Stethoscope - 42. ) Endtidal CO

2

43. ) Pulse oximeter27

28

29

30

31

Vareculla

32

33

34

35

Advantage 1) Comfortable for prolong intu

iiiiii ii iiiiiiiiiiiii iiiiii 2 ) :Suitable for oral surgery to

nsillectomy , mandible surgery 3 ) For blind nasal intubation 4 ) Can take oral feeding 5) Resist for kinking and difficul

i ii iiiiiiiiii iiiiiiiiii36

1) Trauma to nasal mucosa 2) Risk for sinusitis in prolon

i iiiiiiiiii 3) Risk for bacteremia 4) Smaller diameter than or

iiiii -i iiiiiiiii iii ii>iiiii

37

1) Fracture base of skull 2) Coagulopathy 3) Nasal cavity obstruction 4) Retropharyngeal abscess

38

i iiiii iiiiiiiiii1 ) :Traumato l i p,tongue or teeth : Hypertension and tachyc

ardia or arrhythmia : Pulmonary aspiration : Laryngospasm : Bronchospasm

39

1) During intubation iiiiiiiii iiii i:

: i iiiiiiiiiii -i iiii>iiiiii

: Increased intracranial pressiii

:Spi nal cordtrauma i ncervi cai iiiii iiiiii

:Esophageal i ntubati on

40

: Obstruction from klinking , secretion or overinflation of cuff : Accidental extubation or endobronchial intubation : Disconnection from breathing circuit

2) During remained intubation

41

2) During remained intubation

: Pulmonary aspiration : Lib or nasal ulcer in case

with prolong period of intubation

: Sinusitis or otitis in case with prolong nasoendotrac heal intubation

42

3) During extubation Laryngospasm Pulmonary aspiration Edema of upper airway

43

4) After extubation

Sore throat Hoarseness Tracheal

stenosis (Prolong intubation)

Laryngeal granuloma

44

45