Page 407 - ACCCN's Critical Care Nursing

384 P R I N C I P L E S A N D P R A C T I C E O F C R I T I C A L C A R E

FIGURE 15.1 Nasopharyngeal airways. 272

FIGURE 15.2 Laryngeal mask airways. 272

INTUBATION

Endotracheal intubation is the ‘gold standard’ for airway
support, providing airway protection in the presence of
an airway oedema, absent gag, cough or swallow reflex.
Intubation facilitates delivery of mechanical ventilation
and pulmonary secretion clearance. 16

ENDOTRACHEAL TUBES
Endotracheal tubes (ETT) are available with internal
diameters ranging from 2–10 mm (common adult sizes 272
are 7–9 mm), and are up to 30 cm long. A longitudinal FIGURE 15.3 Endotracheal tube.
radio-opaque line allows visualisation of tube placement volumes, but are commonly high-volume, low-pressure
on a chest X-Ray. Markings at 1 cm intervals indicate (see Figure 15.3).
the length from the distal end. Tubes are available
with and without a distal cuff. Adults typically require a Endotracheal tubes may be reinforced with a wire coil
cuffed ETT to seal their trachea, facilitating positive pres- embedded within the plastic for the entire length of the
sure ventilation and preventing aspiration of oropharyn- tube to prevent kinking and occlusion. These tubes are
21
geal contents. Cuffs come in a range of profiles and more commonly used in the operating room. The wire