Face mask
Oxygen mask with a reservoir bag
Oropharyngeal airway - for airway obstruction
Siz: measure the distance from the mouth to the
mandible
Pt. shouldn't have any reflexes(comatose, drunk, or
sedated)
Nasopharyngeal tube - for obtained pt not comatose
Size: from the nose to the ear lobule
We press on the tip of the nose and see where is the
septum deviating we intubate through the other one(wid
space)
Cuffed endotracheal tube Plain endotracheal tube
For pediatric age group
ID: internal diameter; OD: outer diameter
Blue line inferiorly is radio-opaque for CXR
Cuffed and plain tubes for pediatrics
Indications for intubation:
Anesthesia
Ventilation
Protect airway in coma or trauma pt
Complications:
Esophageal intubation
Barotrauma(pneumothorax)
Lung collapse
How to intubate? Using a laryngoscope
Curved and straight blades
Armored tube, never obstructed.
Feeding tube
Laryngeal mask, temporary use bcz of risk of
aspiration; for anesthesia and facilitate intubation
using and introducer
Suction catheter
Nasogastric tube(NGT)
Radio-opaque
Prevents collapse of stomach
Auscultation to know that we
are in position
The smaller the gauge, the larger the diameter of the IV cannula, and the higher the flow.
For major surgery we use 14, 16, or 18
gauge; we need to use local anesthesia.
Components: stylet(needle), and cannula
Central line
Femoral: easier access, higher infection rate. VAN
Subclavian: less infection, opened vein(never collapse), pneumo or Hemothorax risk.
Midclavicular line to suprasternal notch
Internal jugular vein: compressible
Central line kit
When we advance the guide wire we look at the
ECG, if we have arrhythmia then we are in perfect
site.
Indications: TPN, measure pressure, medication,
collapsed peripherals, blood collection and
transfusion.
Complications: damage nearby tissue, pneumo or
Hemothorax, air embolism, hematoma, infection,
arrhythmia,
Interosseous cannula, if central and
peripheral access fails.
Emissary veins drain the blood in
the marrow to the peripheral
circulation.
Access: 2 fingers medial to the tibial
tuberosity.
Spinal needles indications: dural LP, spinal anesthesia, measure CS pressure, medications
Complications: epidural hematoma, infection, epidural abscess, headache, spinal cord
injury if we approach above L2, if below cauda equina injury can ensue, Bradycardia and
hypotension due to throcaolumbar anesthesia treated by vasoactive drugs and IV fluids.
Epidural needle
Indications: epidural anesthesia, and analgesia. Used commonly for labor analgesia and post-
op analgesia.
Similar complications to spinal anesthesia, also numbness which is due to compression and
treated by laminectomy.
CSF Headache is more severe but usually self limiting with 3-5 days. Treated if unbearable or
> 5 days by lying down, paracetamol, coffee, caffiene tablets or injection, or theophylline.
Last resort is blood patch(draining blood from the periphery and reinjection into the epidural
access.
*the difference between anesthesia and analgesia is the drug concentration
Peripheral nerve stimulator needle for nervous block.
Inject medication into a nerve that has motor function to test for it.