Airway Management Endotracheal Tubes

Transcription

1 Endotracheal Tubes

2 Introducing Unomedical Unomedical as a leading manufacturer and supplier of singleuse medical devices offers a broad range of high quality Airway-Management devices, designed to provide advanced solutions accommodating the requirements of medical professionals worldwide. All Unomedical products are processed by high quality materials with the maximum possible accuracy enabling Unomedical to meet the exceptional levels of safety, functionality and reliability that have become a Unomedical hallmark for more than 30 years. Unomedical groups its range of Airway Management solutions into three categories: Airways Artificial airways for anaesthesia, emergency and intensive care ventilation Intubation Devices for the introduction and intubation of artificial airways Airways Clearance Clearance Tracheobronchial suctioning devices for airway maintenance and clearance Intubation Endotracheal Tubes Unomedical offers a wide range of state-of-the-art Endotracheal Tubes with unique benefits for increased patient safety. Such as the Unomedical Colour Coding System which clearly indicates the correct suction catheter calibre to be used together with the chosen Endotracheal Tube, helping to avoid potential high levels of PEEP and/or high subatmospheric pressure levels in the lower airways.

3 Endotracheal Tubes Safety Functionality Reliability UnoFlex - Reinforced Endotracheal Tubes Unomedical Colour Coding System... 4 Standard Endotracheal Tubes... 6 Adult Endotracheal Tubes... 6 Pediatric Endotracheal Tubes... 7 Tube-Fix... 7 Naso-Fix... 7 Intensive Care Endotracheal Tubes... 8 Extended Volume Low Pressure (EVLP)... 8 EXTRA SOFT Pediatric Endotracheal Tubes... 8 Preformed Endotracheal Tubes... 9 Oral Preformed Endotracheal Tubes... 9 Nasal Preformed Endotracheal Tubes... 9 Oxford Endotracheal Tubes... 9 Preformed Endotracheal Tubes Reinforced Endotracheal Tubes UnoFlex Accessories Unomedical Intubation Stylets Guedel Airways MiniSpacer In-Line MDI Intensive Care Endotracheal Tubes The Complete Range Accessories Standard Endotracheal Tubes

4 Unomedical Colour Coding System Risks of tracheobronchial suctioning Suction procedures can cause impairment in gas exchange and lung mechanics including serious effects such as alveolar collapse, hypoxemia and desaturation. Amongst other factors, such as ventilation mode and suction force used, the size of the suction catheter chosen can significantly influence the incidence of such effects. Minimising the risk In order to minimise such effects, the calibre of the suction catheter should be choosen in relation to the inner diameter of the endotracheal/tracheostomy tube. The diameter of the suction catheter should be close to half the inner diameter of the airway used in order to provide sufficient room for ambient air to flow in. Since endotracheal tubes are identified by inner diameter (I.D.) and suction catheters by their Charrière (CH) or French (F) size, indicated by their colour coding, making the right choice is not always easy. The Unomedical Colour Coding System Always the right choice 1 Unomedical s Colour Coding System clearly indicates the appropriate suction catheter size, eases the choice for the medical professional and increases overall safety during suction procedures. All Unomedical Airways are equipped with a colour coded 15 mm connector reflecting the standardised** colour code of the recommended suction catheter. 2 3 References: Stenqvist O, Lindgren S, Karason S, Sondergaard S, Lundin S. Warning! Suctioning. A lung model evaluation of closed suctioning systems. Acta anaesthesiologica Scandinavica VOL:45(2); p /2001 Almgren B, Wickerts CJ, Heinonen E, Hogman M. Side effects of endotracheal suction in pressure- and volume controlled ventilation. Chest 2004;125:

5 Tube/Cannula Recommended Catheter size* Colour Code I.D. (mm) O.D. (mm) O.D. (CH) Suction Catheters** Unomedical Tubes/Cannulas * In some cases catheter sizes slightly larger than 1/2 the diameter of the tube have been choosen to provide more effective removal of secretions. ** According to EN 1733 CH 06 CH 10 CH 14 CH 08 CH 12 CH 16 Airway/Lung model illustrating the reason for adverse effects when using a too large suction catheter calibre. During suctioning, the suction catheter (1) creates a negative suction force, causing sub atmospheric pressure in the lower airways/lung (3). Portion of inflowing air through the Endotracheal tube/ upper airways (2) is too poor to compensate since the suction catheter is blocking most of the lumen, inducing potential alveolar collapse. In case a suction catheter with an appropriate size has been chosen, enough room for ambient air to flow in and to minimise the effect of negative pressure is provided. Almgren, B; Endotracheal Suction a Reopened Problem. Acta Universitatis Upsaliensis. Digital Comprehensive Summaries of Uppsalla Dissertations from the Faculty of Medicine 11.55pp. Uppsala; 2005 AARC Clinical Practice Guideline. Endotracheal Suctioning of Mechanically Ventilated Adults and Children with Artificial Airways. Respir Care 1993;38:

6 Standard Endotracheal Tubes Adult Endotracheal Tubes Colour Coding System Colour coded 15 mm connector for easy and quick identification of the correct suction catheter size (see also page 4-5 f.) Atraumaticity Gently rounded, drawn in bull nose tip ensures atraumatic and smooth intubation and facilitates fiberoptic intubation Easy Identification and Traceability Pilot ballon with tube size in mm ID and control number fills responding to the cuff and clearly indicates fill status Improved Position Control Grading in 1 cm steps provides reliable control of the tube position Effective Seal Thin walled and barrel shaped High Volume Low Pressure (HVLP) cuff for gentle and effective sealing Accurate Positioning Double ring marking helps to guide intubation by laryngoscopy ensuring accurate placement Perfect Adaption Radiopaque X-ray line Facilitates verification of tube positioning visible to the tip Soft, thermosensitive and kink resistant material ensures optimal anatomical adaption Optional Murphy Eye Smoothly formed to avoid vocal cord damage during intubation Gentle Intubation A soft transition between cuff and shaft without sharp edges provides atraumatic and smooth in- and extubation Available configurations HVLP Plain (uncuffed) Murphy Tip Magill Tip

7 Standard Endotracheal Tubes Pediatric Endotracheal Tubes Optional Murphy Eye Smoothly formed to avoid vocal cord damage during intubation and to prevent obstruction Atraumaticity Gently rounded, drawn in tip for atraumatic and smooth intubation Thin Walled Superior relationship of inner and outer diameter Accurate Depth Positioning A grading in 1 cm steps and a black line at the tip of the tube provide support for accurate positioning and repositioning Perfect Adaption Soft, thermosensitive and kink resistant material ensures optimal anatomical adaption Colour Coding System Colour coded 15 mm connector for easy and quick identification of the correct suction catheter size (see also page 4-5 f.) Available configurations HVLP Plain (uncuffed) Murphy Tip Magill Tip Tube-Fix Securement device for endotracheal tubes Designed to secure the position of orally intubated endotracheal tubes Minimum risk of pressure point creation Easy access to oral cavity and throat Two versions for securement with or without additional Guedel Airway Naso-Fix Securement tape for nasal tubes & catheters Secure fixation of nasal tubes Prevents displacement/saves time on re-introduction Optimum patient comfort Skin friendly fixation at optimum angle Discrete appearance Skin coloured/available in 3 different sizes Easy application and removal Efficient securement with minimum time consumption Please ask us for detailed information on our complete securement device programme

8 Intensive Care Endotracheal Tubes Extended Volume Low Pressure (EVLP) Endotracheal Tube Unomedical ELVP Endotracheal Tubes feature a special cuff of 1½ times the average trachea size, maintaining an improved low-pressure sealing during tracheal expansion and contraction. The increased length of the cuff reduces mucosal irritation by pressure distribution against a wider area of the tracheal tissue and provides improved protection against micro aspiration of fluid along the cuff. The cuff of the tube provides vertical elasticity against the tube shaft in order to buffer short-term intratracheal pressure (e.g. coughing) keeping the tube in correct position. EVLP Endotracheal Tubes include all features of Unomedical Standard Endotracheal Tubes including: Colour Coding System Gently rounded and drawn in bull nose tip Soft thermosensitive and kink resistant material Soft transition between cuff and shaft without sharp edges Responsive pilot ballon with tube size and control number print Available configurations Murphy Tip Magill Tip EXTRA-SOFT Pediatric Endotracheal Tube Pediatric Endotracheal Tube made from extremely soft special compound material for improved adaption to the airway anatomy, created for medium and long term ventilation in neonatal and pediatric Intensive Care. Soft material for improved adaption to the respiratory anatomy Transparent tube allows identification of condensation Superior relationship of inner and outer diameter EXTRA-SOFT Tubes include all features of Unomedical Standard Pediatric Endotracheal Tubes including: Colour Coding System Gently rounded and drawn in tip Grading in 1 cm steps and black line at tube tip for easy (re-) positioning

9 Preformed Endotracheal Tubes Oral Preformed/Nasal Preformed Unomedical Preformed Endotracheal Tubes are designed to direct the anaesthesia circuit away from the operative field - either in cranial or in caudal direction. Unomedical Preformed Endotracheal Tubes are available in a variety of configurations including pediatric and adult versions. Colour Coding System Easy and quick suction catheter identification Bull nose tip Gently rounded drawn in tip for maximum atraumaticity during intubation Soft thermosensitive material For optimal anatomical adaption Soft transition between cuff and shaft Transition without sharp edges provides atraumatic in- an extubation Double ring markings Accurate laryngoscopic tube positioning Responsive pilot ballon Clearly indicates fill status and provides important information Available configurations HVLP Plain (uncuffed) Murphy Tip Oxford Endotracheal Tubes Unomedical Oxford Endotracheal Tubes are preformed according to the two axes of the human airway anatomy. The have been designed for quick oral introduction, especially during emergency situations. 90 preformed shaft minimises the risk of kinking and dislocation in the oropharynx The rounded and drawn in tip is adjusted to the backside of the tube minimising the risk of hangups during glottic passage Unomedical Oxford Endotracheal Tubes feature a true High Volume Low Pressure (HVLP) cuff for prolonged ventilation without the need to exchange the tube. The proximal (horizontal) shank of the tube is prolonged in order to provide more room for efficient securement.

10 10 UnoFlex Reinforced Endotracheal Tubes The advanced Reinforced Endotracheal Tube Through innovation, UnoFlex is specially designed using a flat spiral wire embedded in the wall of the tube. This construction allows thicker protective layers around the wire minimising the risk of obstruction even under hardest conditions, while providing an excellent relationship of inner and outer diameter. UnoFlex features an additional X-ray line until the tip providing reliable inspection of tube positioning by chest radiography. Unomedical s spiral wire Conventional spiral wire Increased strength Easy Identification and Traceability Pilot ballon with tube size in mm ID and control number fills responding to the cuff and clearly indicates fill status Increased Safety Radiopaque line up to the tip Effective Seal Thin walled and barrel shaped High Volume Low Pressure (HVLP) cuff for gentle and effective sealing Colour Coding System Colour coded 15 mm connector for easy and quick identification of the correct suction catheter size (see also page 4-5 f.) Atraumaticity Gently rounded, drawn in bull nose tip ensures atraumatic and smooth intubation and facilitates fiberoptic intubation Accurate Positioning Double ring marking helps to guide intubation by laryngoscopy ensuring accurate placement Available configurations HVLP Optimal Adaption Extremely flexible and soft material for optimal anatomical adaption Plain (uncuffed) Murphy Tip Magill Tip

11 11 Accessories Unomedical Intubation Stylets Facilitates quick intubation of endotracheal tubes Low friction between stylet and the tracheal tube for easy insertion and withdrawal Smooth molded distal tip end Soft, slippery sheath extends past distal metal end to form atraumatic tip to reduce trauma during intubation Size 14 Size 10 Size 8 Guedel Airways Designed to maintain a secure Oropharyngeal airway for the unconscious patient in the Pre- Hospital Care and Hospital environment, under general anesthesia or during recovery. All sizes are colour coded for easy accessibility. Rounded atraumatic edges Smooth airway path for easy airway suctioning Bite block to prevent biting of tongue or Endotracheal tube Colour coded for easy identification of sizes Single packed/sterile MiniSpacer In-line MDI Metered Dose Inhaler adapter for in-line application of therapeutic aerosols during Anaesthesia Intensive Care ventilation Manual pulmonary resuscitation The MiniSpacer features a bi-directional aerosol plume, improving delivery of the MDI medication. 15 mm O.D. x 15 mm I.D. adaptor for placement directly to the Endotracheal Tube or to a closed suction system.

12 The Complete Range 12 Standard Endotracheal Tubes REF Magill, HVLP Cuff With Murphy Eye REF I.D. (mm) Size O.D. (mm) Length* (mm) MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM Magill, Plain (without cuff) MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM Intensive Care Endotracheal Tubes Magill, EVLP Cuff MM MM MM MM MM MM MM MM MM MM MM MM MM MM Magill Plain (without cuff), EXTRA-SOFT MM MM MM MM MM MM MM MM MM MM MM MM * Length w/o connector

13 13 The Complete Range Preformed Endotracheal Tubes REF With Murphy Eye REF I.D. (mm) Size O.D. (mm) Length* (mm) * Oral preformed, HVLP Cuff MM MM MM MM MM MM MM MM MM MM Oral preformed, Plain (without Cuff) MM MM MM MM MM MM MM MM * Nasal preformed, HVLP Cuff MM MM MM MM MM Nasal preformed, Plain (without Cuff) MM MM MM MM MM MM MM MM Oxford Tubes MM ** MM ** MM ** MM ** * Length according to Illustration ** Length w/o connector

14 The Complete Range 14 REF Reinforced Endotracheal Tubes With Murphy Eye REF I.D. (mm) Size O.D. (mm) Length* (mm) Magill, HVLP Cuff MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM Magill, HVLP Cuff - Preloaded with Intubation Stylet MM MM MM MM MM MM MM MM MM Magill, Plain (without cuff) MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM MM Magill, Plain (without cuff) - Preloaded with Intubation Stylet MM MM MM MM MM MM MM MM MM Accessories REF * Length w/o connector ** Total length I.D. (mm) Size O.D. (CH) Length** (mm)/ Colour Code Intubation Stylets MM MM MM Guedel Airways, single-packed sterile Blue Black White Green Orange Red MiniSpacer InLine MDI Single, clean packed InLine Metered Dose Inhaler Adapter Unomedical a/s Kongevejen 2 DK-3460 Birkeroed Denmark Kilhof Grafisk GB All Unomedical products are CE-marked according to the Directive 93/42/EEC concerning medical devices. Phone: Telefax: