气道插管课件.pptx

一、概述;气道管理的基本措施

ThePrimarySkillsOfAirwayManagement;上呼吸道的结构和功能;鼻Nose;咽Pharynx;咽Pharynx;喉Larynx;喉Larynx;喉Larynx;气管Trachea;气道的评估

EVALUATIONOFAIRWAY;面罩通气的相关设备及技术

MASKS:VENTILATIONEQUIPMENTANDTECHNIQUE;单手法

Themaskisheldwithonehand,asshowninFigure.Thefingersshouldbekeptontheboneratherthansofttissuesbecausethelatterpositioncancausediscomfortintheawakepatientandcancauseairwayobstructionifsuchpressuresufficientlyraisesthebaseofthetongue.Ventilationwithamaskrequiresatightfitthatinvolvesdownwarddisplacementofthemaskwiththethumbandfirstfingerandupwarddisplacementofthemandiblewiththeotherthreefingers.;双手法

Mandibulardisplacementalongwithuppercervicalextensionandchinliftalltendtopullthetongueandsofttissuesupofftheposteriorpharyngealwallandrelievetheupperairwayobstructionthatoccursintheanesthetizedorunconsciouspatient.Thismayrequireholdingthemaskwithtwohandsandvigorouslypullingthemandibleupward(jawthrust);注意事项

对于肥胖、口腔颌面部肿瘤、感染及炎症的病人采用面罩通气可能相当困难；小儿病人若非发生喉痉挛，一般不会出现面罩通气困难。对于老年病人发生全口无牙或缺牙时，采用面罩通气时易漏气，应采用其它防漏装置。此外，进行面罩通气时除出现面罩通气困难外，尚可能出现其它一些严重并发症如胃内容物返流误吸及眼球的损伤，使用时应注意。;注意事项

Maskventilationmaybeextremelydifficultforpatientswithproblemssuchasobesity,tumors,infections,andinflammatorydisorders.Thepediatricpatientusuallypresentslessofaproblemthantheadultbecausethepediatricairwaycanusuallybemanagedbymaskventilationunlesslaryngospasmensues.Providingaleak-freesealwiththemaskmaybeparticularlydifficultintheolder,edentulouspatient,andthismaybehelpedbyleavingdenturesinplace,usingpacking,oremployingamaskstraporassistanttopullupthesaggingcheeks.Inadditiontotheinabilitytoventilate,otherseriousproblemswithmaskventilationincludepulmonaryaspirationandpressuredamagetotheeyes.;气管内插管

ENDOTRACHEALINTUBATION;

气管导管、喉镜、纤支镜、插管钳、管芯、牙垫及其它

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