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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4597_Библиотеки_им_академика_М_И_Перельмана.pdf
362
Index
Tracheostomy patient (continued)
cuff changes with anesthesia with,
172–173
cuff leaks with, 164 –169
around cuff, 165 –169
around tube, 169
within cuff, 164 –165
defective tubes with, 177
discharge disposition with, 323 –324
inflammation with, 174 –175
laryngectomy with ventilator-
dependent, 272–273
breathing with, 272–273
speech with, 272–273
swallowing with, 272–273
missing part with, 177–178
mobilization of secretions for, 221–228
airway humidification in, 227–228
mobility in, 228
suctioning, 221–227
pistoning with, 169
research of experience of, 175 –177
communication, 176
discomfort, 176
eating, 176 –177
suctioning, 176
retained secretions with, 163 –164
stomal erosion with, 173 –174
tube maintenance in care of, 211–221
care of inner cannula with, 213 –214
care of stoma with, 219 –221
care of tube cuff in, 216 –218
changing tube in, 218 –219
cleaning inner cannula with, 214 –216
emergency supplies for, 211–212
securing tube in, 212–213
Tracheostomy-securing devices, 111
Tracheostomy tubes, 41–112
accessories/products with, 103–112
antidisconnect device, 110
caps, 106 –107
corks or stoppers, 108
decannulation plugs, 108
disconnect wedges, 106
disposable/spare inner
cannulas, 109 –110
heat moisture exchanger, 111
speaking valves, 103
stoma maintenance devices, 103 –105
tracheostomy-securing devices, 111
ventilator adapters, 111
with additional suction channel, 83
Blom tracheostomy tube system,
102–103, 133, 205 –207
bronchial hygiene therapy with, 329 –331
bronchorrhea with, 331
change of, 145 –154
bedside, 147
benzodiazepine for, 146
child tracheostomy, 249
classic method for, 148 –149
cuff deflation with, 147
deep subglottic suctioning with, 147
fenestrated tracheostomy tube, 151–153
foam cuff tracheostomy tube, 150 –151
hemodynamically unstable patient
with, 146 –147
nonstandard tube placement in,
150 –153
patient anxiety with, 146
patient cooperation for, 146
patient positioning with, 147
railroad method for, 149 –150
stoma examination with, 148 –149
supplies for, 146 –147
survey of chief residents regarding,
145 –146
tube exchanger technique for, 149 –150
characteristics for ventilation requiring
patients of, 335
dual- v. single-cannula, 335
ease of changing, 335
size, 335
child attending school with, 261
child, selection of, 246 –248
cough strength/reflex with choice of, 331
cuffed v. uncuffed choice of, 117–120
airway protection in, 119 –120
mental status in, 120
positive-pressure ventilation in,
117–118
transitioning with, 338
custom-designed, 101–102
defective, 177
diameters of
adult, 122–132
neonatal and pediatric, 137–143
double-cuffed, 99
dual-cannula cuffless, 54 – 61
Portex DIC Uncuffed, 55
Portex Flex DIC Uncuffed, 56
Portex Lo-Profile Uncuffed, 60 – 61
Index
363
Shiley CFS, 57
Shiley DCFS, 58
TRACOE Comfort, 60
TRACOE Twist Cuffless, 59
dual- v. single-cannula choice for,
120 –121
secretions and tube obstructions in,
120
suctioning in, 121
ventilation requiring patients with,
335
extra-long, 77– 83
Arcadia Air Cuff Adjustable-Neck
Flange, 79
Bivona Hyperflex, 78
Portex Blue Line Extra Horizontal
Length, 82– 83
Shiley TracheoSoft XLT, 80
TRACOE Comfort Extra Long, 82
TRACOE Vario, 81
fenestrated, 93 –99, 149 –152, 338
phonation with, 187–189
Portex Blue Line Fenestrated, 96
Portex Blue Line Ultra Fenestrated, 96
Portex DIC Fenestrated, 95
Portex Flex DIC Fenestrated, 95 –96
Portex Lo-Profile Fenestrated, 96
Shiley Fenestrated, 94 –95
TRACOE Comfort Fenestrated, 98
TRACOE Twist Fenestrated, 97
fitting/changing of, 115 –155
assessing resistance with, 116 –117
child in, 249
choosing best tube construction with,
143 –144
choosing best tube length with, 144
choosing cuffed/uncuffed tube with,
117–120
choosing dual/single-cannula tube
with, 120 –121
choosing tube size with, 121–141
considerations with, 115 –116
goals before, 115 –116
matching tube shape and airway with,
144 –145
patient care with, 218 –219
phonation with tube choice in, 144 –145
questions for planning, 115 –116
laryngectomy tubes, 88 –93
Bivona Laryngectomy, 93
Portex DIC Laryngectomy, 89 –90
Provox LaryTube, 93
Shiley LGT, 89
Singer Laryngectomy, 92
TRACOE Comfort Laryngectomy, 91
TRACOE Twist Laryngectomy, 90
maintenance of, 211–221
care of inner cannula with, 213 –214
care of stoma with, 219 –221
care of tube cuff in, 216 –218
cleaning inner cannula with, 214 –216
material of, 41
polyurethane, 41
polyvinyl chloride, 41
silicone, 41
silver, 41
stainless steel, 41
metal, 41, 83 – 88, 130
cleaning of, 216
Holinger, 85
Jackson, 84 – 85
Luer, 88
Martin, 87
Mayo Clinic, 87
Tucker, 86
mini, 101
missing part with, 177–178
new products, 102–103
Nomori ventilator talking, 205
nonstandard, 150 –153
fenestrated tracheostomy
tube, 151–153
foam cuff tracheostomy tube, 150 –151
obstruction of, 120, 286 –287
parts of, 42– 47
balloon valve, 42
cuff, 42, 43, 45 – 47
inflation line, 42, 45
inner cannula, 42, 44
neck flange, 42, 45
obturator, 42, 44 – 45
outer cannula, 42, 43
pilot balloon, 42, 45
phonation with capping/corking/
plugging of, 186 –187
pistoning with, 169
rehabilitation need based on choice of,
325, 329 –331
related supplies for, 112
bibs, 112
grid or mesh screens, 112
scarves or ascots, 112
364
Index
Tracheostomy tubes (continued)
shower protections devices, 112
tube spacers, 112
securing, 212–213
single-cannula cuffed, 61– 69
Arcadia Foam Cuff, 67
Arcadia Silicone Air Cuff, 65
Arcadia Silicone CTS Cuff, 69
Bivona Fome Cuf, 66 – 67
Bivona Mid-Range Aire-Cuf, 64
Bivona TTS, 68 – 69
Portex Blue Line, 62
Portex Blue Line Ultra, 63
Shiley SCT, 61
single-cannula cuffless, 69 –75
Air-Lon Tracheostomy Tube and
Inhalation Set, 70 –71
Arcadia Silicone Cuffless, 74
Bivona Sleep Apnea, 74 –75
Bivona Uncuffed, 70
Moore, 73
Portex Blue Line Ultra Uncuffed, 72–73
Portex Blue Line Uncuffed, 72
TRACOE Comfort, 71
size of, 121–141
adult, 122–132
airflow in, 143
Air-Lon, 122
Arcadia adjustable-neck flange, 122
Arcadia Foam Cuff, 122
Arcadia Silicone Air Cuff, 122
Arcadia Silicone CTS Cuff, 123
Arcadia Silicone Cuffless, 122
Bivona Fome Cuf, 123
Bivona Fome-Cuf With Talk
Attachment, 133
Bivona Hyperflex, 123
Bivona Mid-Range Aire-Cuf, 123
Bivona Sleep Apnea, 124
Bivona TTS, 124
Bivona Uncuffed, 124
Blom tracheostomy tube system, 133
decannulation dependent on, 309
Holinger, 134
Jackson, 131
Luer, 132
Martin, 132
Mayo Clinic, 132
Moore, 124
neonatal and pediatric, 137–143
Portex Blue Line, 125
Portex Blue Line Extra Horizontal
Length, 126
Portex Blue Line Trach Talk, 133
Portex Blue Line Ultra, 126
Portex Blue Line Ultra fenestrated, 127
Portex Blue Line Ultra Suctionaid, 127
Portex DIC, 124
Portex DIC fenestrated, 125
Portex Flex DIC, 125
Portex Flex DIC fenestrated, 125
Portex Lo-Profile, 127
Portex Lo-Profile fenestrated, 127
Portex Per-Fit, 126
Shiley DCT, 127, 129
Shiley fenestrated, 128
Shiley PERC, 129
Shiley SCT, 128
Shiley TracheoSoft XLT, 129
Talking, 133
TRACOE Comfort, 130
TRACOE Comfort Extra Long, 130
TRACOE Twist Series, 129
TRACOE Twist With Air Supply Line,
134
TRACOE Vario, 130
Tucker, 131
sizing of, 43 – 44
speaking, 334
special use, 75
standard dual-cannula cuffed, 47–54
Portex DIC, 51–52
Portex Flex DIC, 52–53
Portex Lo-Profile, 54
Portex Per-fit, 51
Shiley DCT, 49
Shiley LPC, 48
Shiley PERC, 50
TRACOE Twist Series, 53 –54
talking, 75 –77
Bivona Fome-Cuf With Talk
Attachment, 77
Portex Blue Line Trach Talk, 76
TRACOE Twist With Air Supply
Line, 76
tracheomalacia and repositioning of, 118
transitioning, 337–339
cuffless tubes with, 338
downsizing with, 338
fenestrated tubes with, 338
one-way valves with, 338 –339
TTS tubes with, 338
Index
365
T-tubes, 99 –101
upper airway obstruction evaluation
of, 336
voice, 334
Tracheotomy. See also Open tracheotomy;
Percutaneous dilational
tracheotomy
anesthesia management for, 21–25
complications with, 25
emergence in, 25
equipment in, 22–23
induction in, 23
maintenance in, 23 –25
monitoring in, 23
premedication in, 22
preoperative evaluation in, 21–22
technique in, 22
checklist for bedside, 23
endotracheal intubation v., 19
indications for, 18 –19
laryngotracheal trauma, 19
severe angioneurotic edema, 19
upper aero-digestive tract neoplasm, 19
postoperative care with, 37–38
preoperative management for, 20 –21
procedure, 17–38
surgical technique for, 25 –38
anatomy of, 25 –26
open tracheotomy, 26 –30
pediatric tracheotomy, 37
percutaneous dilational tracheotomy,
30 –37
timing of, 19 –20
Tracheotomy dilator, 29
TRACOE Comfort Extra Long
tracheostomy tubes, 82
diameters of, 130
TRACOE Comfort fenestrated
tracheostomy tubes, 98
TRACOE Comfort laryngectomy tubes, 91
TRACOE Comfort tracheostomy tubes, 71
diameters of, 130
TRACOE decannulation plug, 108
TRACOE Twist fenestrated tracheostomy
tubes, 97
TRACOE Twist laryngectomy tubes, 90
diameters of, 137
TRACOE Twist Series tracheostomy tubes,
53 –54
diameters of, 129
TRACOE Twist With Air Supply Line
tracheostomy tubes, 76
diameters of, 134
TRACOE Vario tracheostomy tubes, 81
diameters of, 130
Transpulmonary pressure, 12
Traumatic brain injury, 337
Trigeminal nerve, 10
T-tubes, 99 –101
care of, 229 –231
Hood, 230
suctioning, 231
Tube displacement/loss of airway,
tracheostomy complicated by,
285 –286
Tube exchanger technique, 149 –150
Tube obstruction, tracheostomy
complicated by, 120, 286 –287
Tucker tracheostomy tubes, 86
diameters of, 131
Tucker valve, 193, 195
Vagus nerve, 10
VC. See Vocal cords
Ventilator adapters, 111
Vocal cord paralysis, 18
speaking valves use contraindicated by,
196
Vocal cords (VC), phonation and
inspiration with position of, 6 –7
Voice restoration, 181–183. See also
Phonation
risk of aspiration with, 182
Voice tracheostomy tube, 334