Thursday, May 15, 2014

SURGIAL INSTRUMENTS 13 Tubes Nasogastric endotracheal tracheostomy







Tubes
Without endotracheal tubes modern anesthesia would be unthinkable. The traditional tubes of the Magill pattern are made of red mineralized rubber. Except for the smallest they all have an inflatable cuff near the distal tip to protect the lower respiratory tract form soiling as well as providing an air-tight seal. Each number refers to the internal diameter of the tube in millimeters.
         All tubes in the past have been made of rubber and have been recycled in practice by autoclaving. All these instruments and nasogastric tubes are now made of nonreactive plastic material and come presterilized in packs. These tubes are all disposable and thus do not require recycling.
         The tubes in use are:
         •       Endotracheal (Fig. 8.79)
         •       Uncuffed oral endotracheal tube (Fig. 8.80)
         •       Negus tracheostomy (Fig. 8.81)
         •       Chevalier Jackson (Fig. 8.82).
Nasogastric
Tubes may have to be passed into the stomach, or even beyond, for decompression, sampling or delivery of drugs or food.
         Ryle’s tube is most commonly used for decompression of the stomach following abdominal surgery or for intestinal obstruction.
         The other tubes used are:
         •       Nasogastric (Figs 8.83A to C)
         •       Sengstaken (Fig. 8.84).

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