By Mihály Boros (editor)
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Additional info for Monitoring in Medical Practice – Basic Medical Skills
With a central venous catheter) in situ Rinsing and ﬂooding of the entry point of air with physiological saline Preparedness for reanimation 4. Endotracheal intubation Deﬁnition: Introduction of a tube through the mouth or nose into the trachea to provide open airways. The principle of the technique is to introduce a plastic or rubber tube of appropriate size into the respiratory system so that its end is situated in the trachea or one of the main bronchi to separate the two lungs. This procedure can be performed in some situations in a conscious state or under local anesthesia, but more frequently it is carried out under general anesthesia or with muscle relaxation.
Diﬀerent drugs may be given to the patients, if needed. 3. 4. The technique of intubation Intubation can usually be performed under direct visualization with the help of a laryngoscope (direct laryngoscopy). Introduction of an endotracheal tube into the larynx through the mouth or nose can be done under narcosis and muscle relaxation, or in deep unconsciousness, or in a state of clinical death. The most widely used intubation technique is as follows: 1. The required equipment, tools and drugs are ﬁrst prepared on the table next to the patient and checked consecutively: A Ruben balloon with valve and mask, or an anesthesia machine with manual ventilation A suction pump with a suction catheter A laryngoscope Endotracheal tubes Tube adaptors A syringe for inﬂation of the cuﬀ A Péan for clamping the duct of the cuﬀ A bite block (a Guedel tube or a 10 × 5 cm gauze strip) Tape or a Köpper band for ﬁxing the tube 35 IV.
3. Inadequate internal respiration Internal respiration is gas exchange between blood and tissue cells. The Hb molecule must be able to oﬀ-load oxygen. Again, the oxygen supply is directed from an area of higher to an area of lower oxygen concentration. g. carbon monoxide poisoning). 2. 003) ) = ~15 vol%=150 mℓ/ℓ Arterio-venous oxygen—partial pressure gradient = CaO₂–CvO₂; normally it is about 5 vol%. 003 × PaO₂ kPa)]. = 520–570 mℓ/ℓ/m² The main determinants of the oxygen delivery are Hg, CO, or CI and SpO₂.