Airway management of painless endoscopy ( Endotracheal intubation and laryngeal mask)

by:Honde     2020-06-04

a, balloon mask and oropharyngeal airway

oropharyngeal airway should be regular, but the actual use may be less, it as an ambulance must have one of the items, generally only in case of an emergency relief tongue fall after use; In the most critical situation directly choose balloon mask or directly endotracheal intubation. If airway secretions are long, I hope we are still ready to oropharynx air passage, sputum suction or endotracheal intubation in transition.

the content of the balloon mask and operation is not much said, mainly is the need to pay attention to when using balloon mask head back must be in place. Head back operation is known to all, but the method of 'slavish' can not open the airway and fully to oxygen. Balloon mask is for relief of hypoxemia, general continuous hypoxemia balloon oxygen masks are temporary transition means, may eventually need to endotracheal intubation.

2, endotracheal intubation,

in cardiopulmonary resuscitation (CPR) in various kinds of airway patency way, endotracheal intubation as 'ultimate' means of unobstructed airway, retaining its position over a long period of time, its position in the endoscopic diagnosis and treatment, especially the painless endoscopy process is also very obvious. Endotracheal intubation requires experience, quickness and the unexpected emergency response ability, these are the anesthesia and the characteristics of emergency department physician should have, so most hospitals or urgent consultation please anaesthesia intubation or the emergency department. But if we met in the process of checking died suddenly, call the emergency department or anesthesia because of all sorts of things can't get to the front of you, psychological, please have a preparation.

3, a laryngeal mask ( Double tube laryngeal mask - - - - - - - Endoscopic)

suffocation if happen, balloon mask can not meet the requirement of the airway patency, the emergency department or anesthesia doctor not immediately appear in front of you, your own endotracheal intubation technique does not pass, how to do? Laryngeal mask may help you. Ordinary double tube laryngeal mask for endoscopic operation of airway management significance is not big, but there is a certain type of product in the laryngeal mask for endoscopic special double tube laryngeal mask; It can not only meet the needs of patent airway intubation, and can offer independent channels in endoscopy.

a laryngeal mask (since the 1980 s LMA) Since generation, the second generation and third generation of laryngeal mask. Because laryngeal mask mainly for anesthesia and emergency applications, endoscopic staff need to know is the third generation of laryngeal mask ( Double tube laryngeal mask) 。 Laryngeal mask, as members of the third gradient of airway management. Mainly responsible for temporary airway unobstructed or short-term airway unobstructed, anesthesia and emergency doctor will have a deeper understanding and endoscopy doctors for understanding only.

with twin tube laryngeal mask (specially endoscope channel Three generations) Can be used in the endoscopic operation, such as critical ERCP or ESD for long, the operation is very easy to airway problems, such as suffocation or persistent low oxygen. As a result of the laryngeal mask into operation does not need too much skill, and convenient to prepare conveniently available, so it is suitable for endoscopic operation. Three generations of laryngeal mask from the previous two generations of technology has improved significantly. Outside increased gastric drainage pipe, but also improved the leakproofness of laryngeal mask and product stability. Which is relatively suitable for endoscopic physicians. Such operations can make up for the inadequacy of endoscopy personnel endotracheal intubation technique, at the same time, less damage and cardiovascular system response on the airway, improving the safety of the endoscopic operation airway management.

4, pay attention to what kind of patients may cause respiratory tract obstruction

for endoscopic examination, especially the painless endoscopy and painless ERCP, airway management in patients need special attention. These patients need your special attention: obesity, sleep suspended syndrome, mouth breathing difficulties, ankylosing spondylitis and former patients with difficult intubation. These patients may lead to you in the process of painless check cause suffocation or is prone to suffocate and difficult intubation. How to note: see the categories patients need special account, intraoperative monitoring, and make ready for oropharyngeal airways, laryngeal mask and endotracheal intubation unobstructed airway, at any time to rescue the unobstructed airway reservior.

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