一千个漏气的喉罩藏着一千个哈姆雷特
(a) CT显示的气道侧面图
(f) 理想的喉罩放置图(正面)
(b) 理想的喉罩放置图(侧面)
理想的喉罩有以下几个要求
(i) (喉罩的远端在食道里面)
(ii) (会厌在罩杯外面)
(iii) (会厌内侧与罩杯耦合)
(iv) (打气要均匀)
(v) (不要折叠你的罩杯)
漏气的你可能包括或不限于下面的各种 (慢慢看英文,就当是学习)
(c) Supraglottic airway device inserted too deep, too small size of SAD, or hypoinflation of the cuff in a manikin. (d) Supraglottic airway device inserted too superficial, too large size of SAD, or hyperinflation of the cuff in a manikin. (e) Downfolding of the epiglottis in the bowl of the SAD in a manikin. (g) Lack of seal between a SAD (non-inflatable cuff) and the epiglottis in a patient. (h) Same as in (c) in a patient. (i) Same as in (d) in a patient. (j) Supraglottic airway device with the epiglottis in the bowl, showing posterior epiglottis (no obstruction). (k) Folding in the proximal polyvinyl chloride cuff causing a leak. (l) Tip of the distal cuff folding over. (m) Tip of the distal cuff sits between the vocal cords. (n) Downfolding of the epiglottis by the distal cuff of the SAD. (o) Folding double of the epiglottis in a patient.
如何调整喉罩,不漏气才是王道
(1)合适的喉罩,别把气密性只有25mmHg的她用在头低脚高位还是大胖子身上
(2)先看下气打得太多还是太少(拿着注射器就要稳、准、狠)
(3)看看是插得太深还是太浅(看着外面露出那么长的杆儿,你就要想到浅了)
(4)纤支镜看看是喉罩折了还是会厌折了(插喉罩还是要点肌松的)
(5)改插管吧(固执只会让你很受伤)
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