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1、2019/4/18,1,Artificial airway management in ICU,General hospital of Ningxia medical university ICU: Wang Lijuan,2019/4/18,2,The concept of artificial airway （人工气道）,Concept: （概念） Artificial airway are breathing passages （呼吸通路）with a catheter（管道） which is inserted （插入）into the trachea （气道）or directly
2、inserted into the trachea through the upper respiratory tract（上呼吸道） ,and assisted ventilation （机械通气）and treatment of lung disease（肺部疾病）.,tracheal intubation (气管插管）and tracheostomy tube （气切套管）,2019/4/18,3,Artificial airway management（管理）,Maintenance（保持） of artificial airway（人工气道） function（功能） Keep re
3、spiratory tract （呼吸通路）unobstructed（通畅） Prevent （防止）complications（并发症）,The most basic requirements（基本要求） of artificial airway,Fixed（固定）,Airtight（密闭）,Unobstructed （通畅）,successfully manage artificial airway,综合关系：强调由几个部分推出一个结论或者对象,The key（关键） and details（细节） of airway management,Oral care:（口腔护理）,Secure
4、fixation（安全固定）,Teeth pad （牙垫）of nursing,keep airway unobstructed通畅,Body position:（体位）,Click to add Title,Prevent mucosal（粘膜） injury,2019/4/18,6,Avoid（避免 ）the pipeline water（积水瓶中的水） pouring（灌入） the artificial airway and timely pouring（倾倒）.,Another important things,To prevent the pipeline distortion（打
5、折）, keep the pipelines unobstructed（通畅）,2019/4/18,7,Teeth pad of nursing（牙垫的护理）,Each shift （每班）check teeth pad and Cannulation（检查） of the close（松紧度） degree,prevent the teeth pad transposition （移位） On the injury or tracheal intubation （气管插管）to be bitted （咬扁）and patient in danger,especially spring tub
6、e（弹簧管）.,Air bag management （气囊的管理）,Maintain appropriate（合适的）pressure of 25-30cmh20(centimeter water column) Airbag is deflated（放气） before the full removal of oral and nasopharyngeal （鼻咽部）secretions（分泌物）, in order to prevent the aspirations and reduced respiratory tract infections. Each shift choose
7、the air bag pressure,prevent the occurrence of catheter ablation（脱落）.,2019/4/18,8,Body position（体位）,The United States of America CDC: No semi-recumbent position contraindication（无体位禁忌症） ,head elevation（床头抬高） 3045 degrees Objective（目标）: to prevent gastroesophageal reflux （胃食管反流）inhalation（吸入）, and pr
8、evention of aspiration（误吸） and prevention the occurrence（发生） of VAP（ventilator associated pneumonia,呼吸机相关性肺炎),2019/4/18,9,Temperature（加温） and humidity（加湿）,There are two types of devices（装置）about temperature and humidity. Heated humidifier（湿化加温器）T24h Bacteria filter（细菌过滤器,也称人工鼻）T24h,heated humidifier
9、（湿化加温器）,Heating water to generate（产生） steam inhalation after, mixed gas, can achieve the dual（双重） purpose of humidification and heating. The appropriate （最佳） temperature of Suction（吸入） gas is 32-36 degrees,2019/4/18,11,2019/4/18,12,Bacterial filter（细菌过滤器),Artificial nose: On the filtration of bacter
10、ia（清除细菌） have certain effect, it can reduce the chance of pipeline be contaminate（污染） by bacterial （细菌） for number of patients who have less sputum（痰液）.,The ventilator heated humidifier（湿化器）and bacterial filter（人工鼻）can not be used at the same time（同时）. it seemed that artificial blocked（人为阻塞） the exh
11、alation passage.（呼气通道）,2019/4/18,13,Remember（切记）,Remember（切记）,Properly connected （正确连接）breathing pipeline（呼吸管路）. The suction pipe（吸气端） connection in the humidifier. It seems to blow bubbles（吹泡泡） into the water continuous（持续的）.,2019/4/18,15,Prevention of airway obstruction（堵塞）,Artificial airway manag
12、ement in the most severe clinical emergency,used to threaten the life of patients! 人工气道管理中最为严重的临床急症, 常常威胁病人生命！,obstruction of the catheter（管道堵塞）,Reason: sputum bolt（痰液堵塞） or a foreign body ( such as blood clot etc.)（异物，如血凝块）obstruction（堵塞） of artificial airway.,obstruction of the catheter（管道堵塞）,Proc
13、essing: washing airway（冲洗人工气道）, irritative cough（刺激患者咳嗽）, sputum diluting the sputum bolt or foreign body aspiration(稀释痰液将痰栓或异物吸出).,obstruction of the catheter（管道堵塞）,Emergency treatment: should immediately （立即）removing endotracheal intubation or tracheostomy tube（拔除气管插管或气切套管）, and then restart the e
14、stablishment of artificial airway（重新建立人工气道）.,2019/4/18,19,Summary:（总结）,Airway management important is in detail 气道管理重在细节 Details determine the quality of nursing 细节决定护理质量 quality of nursing decide the quality of life and safety 质量决定生命安全,2019/4/18,20,Nightingale Maxim（格言）,Nurses work object is not a
15、cold stone, wood and paper, but the blood and life of the human, the nurses job is a fine art in the fine, one reason, is the nurse must have a sympathetic heart and a pair of hands willing to work。,南丁格尔格言,护士的工作对象不是冷冰冰的石块、木头和纸，而是有热血和有生命的人类，护士的工作是精细艺术中之最精细者，其中有一个原因，就是护士必须具有一颗同情的心和一双愿意工作的手。,2019/4/18,22,THANK YOU !,
