《放射医学艺术》PPT课件

《《放射医学艺术》PPT课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、MedicalArtsRadiologyBarryR.Morgenstern,M.D.TubesandLinesWhat,WhereandWhoopsFormatofLectureForeachdeviceWhattheyareandwhattheydoWheretheybelongWhoops–malpositioningandcomplicationsTubeorLineDesiredPositionETTTip2-5cmfromcarinaTracheostomytubetip½waybetween

2、stomaandcarinaCentralvenouscatheterTipinSVCPICCLineTipinSVCSwann-GanzCatheterTipinproximalRorLPulmonaryArteryPleuralDrainageTubeAnterosuperiorforPTX;posteroinferiorforeffusionPacemakerTipatapexofRventricle;other(s)inRAand/orcoronarysinusAICDOneleadinSVC;o

3、therinRventricleNGtubeTipinstomachAirwaysEndotrachealTubesWhatTheyAreUsedForIndicationsforAssistedventilationIsolatetracheatopermitcontrolofairwayPreventsgastricdistensionDirectrouteforsuctioningAdministrationofmedicationsviaETTEndotrachealTubesWhereTipsh

4、ouldbe2-5cmabovecarinaBetweenclaviclesandcarinaCarinausuallyatlevelofT4Tipmaychangeby2cmwithflexion/extensionBalloonshouldneverdistendtrachealwalls;if>2.8cm,suspectlacerationEndotrachealTubesWhoopsMostcommonmalposition:tipinrightmainstembronchusLeadstoat

5、electasis,orRight-sidedtensionpneumothoraxTubeinlarynxorpharynxDamagevocalchordsAspirationR3Tipofendotrachealtube(yellowarrow)lieswellabovethecarina(greenarrow)TracheostomyWhatIndicationsforAirwayobstructionatoraboveleveloflarynxRespiratoryfailurerequirin

6、glong-termintubation(>21days)ObstructionduringsleepapneaParalysisofmusclesthataffectswallowingorrespirationTracheostomyWhereTiphalf-waybetweenstomaandcarinaAboutT3Tipplacementnotaffectedbyflexion/extensionWidthoftubeabout2/3widthoftracheaTracheostomyWhoo

7、psImmediatelyafterSubcutaneousemphysemaPneumomediastinumPneumothoraxCuffshouldnotbe>1½timesdiameteroflumenTrachealstenosisTracheostomyTrachealStenosisMostcommonlate-occurringcomplicationoftracheostomytubeMayoccuratstoma,levelofcufforattipoftubeMostcommona

8、tstomaFibrosiswithdestructionofcartilageAtcuffsite,usually2°tocircumferentialscarR3Tipoftracheostomytube(yellowarrow)liesaboutmidwaybetweenthestoma(bluearrow)andcarina(greenarrow)IntravascularLinesCentralVenousCathe