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Endotracheal Intubation
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction. The most widely used route is orotracheal, in which an endotracheal tube is passed through the mouth and vocal apparatus into the trachea. In a nasotracheal procedure, an endotracheal tube is passed through the nose and vocal apparatus into the trachea. Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated. Because it is an invasive and uncomfortable medi ...
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Anesthesiologist
Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine. A physician specialized in anesthesiology is called an anesthesiologist, anaesthesiologist, or anaesthetist, depending on the country. In some countries, the terms are synonymous, while in other countries they refer to different positions, and ''anesthetist'' is only used for non-physicians, such as nurse anesthetists. The core element of the specialty is the study and use of anesthesia to safely support a patient's vital functions through the perioperative period. Since the 19th century, anesthesiology has developed from an experimental area with non-specialist practitioners using novel, untested drugs and techniques into what is now a highly refined, safe and effective field of medicine. In some countries anesthes ...
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General Anaesthesia
General anaesthesia (UK) or general anesthesia (US) is a medically induced loss of consciousness that renders the patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general anaesthetic medications, which often act in combination with an analgesic and neuromuscular blocking agent. Spontaneous ventilation is often inadequate during the procedure and intervention is often necessary to protect the airway. General anaesthesia is generally performed in an operating theater to allow surgical procedures that would otherwise be intolerably painful for a patient, or in an intensive care unit or emergency department to facilitate endotracheal intubation and mechanical ventilation in critically ill patients. A variety of drugs may be administered, with the overall goal of achieving unconsciousness, amnesia, analgesia, loss of reflexes of the autonomic nervous system, and in some cases paralysis of skeletal musc ...
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Physiology
Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical and physical functions in a living system. According to the classes of organisms, the field can be divided into medical physiology, animal physiology, plant physiology, cell physiology, and comparative physiology. Central to physiological functioning are biophysical and biochemical processes, homeostatic control mechanisms, and communication between cells. ''Physiological state'' is the condition of normal function. In contrast, ''pathological state'' refers to abnormal conditions, including human diseases. The Nobel Prize in Physiology or Medicine is awarded by the Royal Swedish Academy of Sciences for exceptional scientific achievements in physiology related to the field of medicine. Foundations Cells Although there are di ...
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Anatomy
Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having its beginnings in prehistoric times. Anatomy is inherently tied to developmental biology, embryology, comparative anatomy, evolutionary biology, and phylogeny, as these are the processes by which anatomy is generated, both over immediate and long-term timescales. Anatomy and physiology, which study the structure and function of organisms and their parts respectively, make a natural pair of related disciplines, and are often studied together. Human anatomy is one of the essential basic sciences that are applied in medicine. The discipline of anatomy is divided into macroscopic and microscopic. Macroscopic anatomy, or gross anatomy, is the examination of an animal's body parts using unaided eyesight. Gross anatomy also includes the br ...
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Medical Ventilator
A ventilator is a piece of medical technology that provides mechanical ventilation by moving breathable air into and out of the lungs, to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently. Ventilators are computerized microprocessor-controlled machines, but patients can also be ventilated with a simple, hand-operated bag valve mask. Ventilators are chiefly used in intensive-care medicine, home care, and emergency medicine (as standalone units) and in anesthesiology (as a component of an anesthesia machine). Ventilators are sometimes called "respirators", a term commonly used for them in the 1950s (particularly the "Bird respirator"). However, contemporary medical terminology uses the word " respirator" to refer instead to a face-mask that protects wearers against hazardous airborne substances. Function In its simplest form, a modern positive pressure ventilator, consists of a compressible air reservoir or turbine, air and oxy ...
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Bag Valve Mask
A bag valve mask (BVM), sometimes known by the proprietary name Ambu bag or generically as a manual resuscitator or "self-inflating bag", is a hand-held device commonly used to provide positive pressure ventilation to patients who are not breathing or not breathing adequately. The device is a required part of resuscitation kits for trained professionals in out-of-hospital settings (such as ambulance crews) and is also frequently used in hospitals as part of standard equipment found on a crash cart, in emergency rooms or other critical care settings. Underscoring the frequency and prominence of BVM use in the United States, the American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care recommend that "all healthcare providers should be familiar with the use of the bag-mask device." Manual resuscitators are also used within the hospital for temporary ventilation of patients dependent on mechanical ventilators when the mechanical ventilato ...
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Pulmonary Aspiration
Pulmonary aspiration is the entry of material such as pharyngeal secretions, food or drink, or stomach contents from the oropharynx or gastrointestinal tract, into the larynx (voice box) and lower respiratory tract, the portions of the respiratory system from the trachea (windpipe) to the lungs. A person may inhale the material, or it may be delivered into the tracheobronchial tree during positive pressure ventilation. When pulmonary aspiration occurs during eating and drinking, the aspirated material is often colloquially referred to as "going down the wrong pipe". Consequences of pulmonary aspiration range from no injury at all, to chemical pneumonitis or pneumonia, to death within minutes from asphyxiation. These consequences depend on the volume, chemical composition, particle size, and presence of infectious agents in the aspirated material, and on the underlying health status of the person. In healthy people, aspiration of small quantities of material is common and ra ...
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Tracheobronchial Tree
The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa. Air is breathed in through the nose to the nasal cavity, where a layer of nasal mucosa acts as a filter and traps pollutants and other harmful substances found in the air. Next, air moves into the pharynx, a passage that contains the intersection between the oesophagus and the larynx. The opening of the larynx has a special flap of cartilage, the epiglottis, that opens to allow air to pass through but closes to prevent food from moving into the airway. From the larynx, air moves into the trachea and down to the intersection known as the carina that branches to form the right and left primary (main) bronchi. Each of these bronchi branches into a secondary (lobar) bronchus that branches into tertiary (segmental) bronchi, that branch into smaller airways called bronchioles tha ...
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Trachea
The trachea, also known as the windpipe, is a cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all air- breathing animals with lungs. The trachea extends from the larynx and branches into the two primary bronchi. At the top of the trachea the cricoid cartilage attaches it to the larynx. The trachea is formed by a number of horseshoe-shaped rings, joined together vertically by overlying ligaments, and by the trachealis muscle at their ends. The epiglottis closes the opening to the larynx during swallowing. The trachea begins to form in the second month of embryo development, becoming longer and more fixed in its position over time. It is epithelium lined with column-shaped cells that have hair-like extensions called cilia, with scattered goblet cells that produce protective mucins. The trachea can be affected by inflammation or infection, usually as a result of a viral illness affecting othe ...
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Vocal Cords
In humans, vocal cords, also known as vocal folds or voice reeds, are folds of throat tissues that are key in creating sounds through vocalization. The size of vocal cords affects the pitch of voice. Open when breathing and vibrating for speech or singing, the folds are controlled via the recurrent laryngeal branch of the vagus nerve. They are composed of twin infoldings of mucous membrane stretched horizontally, from back to front, across the larynx. They vibrate, modulating the flow of air being expelled from the lungs during phonation. The 'true vocal cords' are distinguished from the 'false vocal folds', known as vestibular folds or ''ventricular folds'', which sit slightly superior to the more delicate true folds. These have a minimal role in normal phonation, but can produce deep sonorous tones, screams and growls. The length of the vocal fold at birth is approximately six to eight millimeters and grows to its adult length of eight to sixteen millimeters by adolesc ...
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Fiberscope
A fiberscope is a flexible optical fiber bundle with an eyepiece on one end and a lens on the other that is used to examine and inspect small, difficult-to-reach places such as the insides of machines, locks, and the human body. History Guiding of light by refraction, the principle that makes fiber optics possible, was first demonstrated by Daniel Colladon and Jacques Babinet in Paris in the early 1840s. Then in 1930, Heinrich Lamm, a German medical student, became the first person to put together a bundle of optical fibers to carry an image. These discoveries led to the invention of endoscopes and fiberscopes. In the 1960s the endoscope was upgraded with glass fiber, a flexible material that allowed light to transmit, even when bent. While this provided users with the capability of real-time observation, it did not provide them with the ability to take photographs. In 1964 the fiberscope, the first gastro camera, was invented. It was the first time an endoscope had a camer ...
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Laryngoscopy
Laryngoscopy () is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during general anaesthesia or cardiopulmonary resuscitation or for surgical procedures on the larynx or other parts of the upper tracheobronchial tree. Direct laryngoscopy Direct laryngoscopy is carried out (usually) with the patient lying on his or her back; the laryngoscope is inserted into the mouth on the right side and flipped to the left to trap and move the tongue out of the line of sight, and, depending on the type of blade used, inserted either anterior or posterior to the epiglottis and then lifted with an upwards and forward motion ("away from you and towards the roof "). This move makes a view of the glottis possible. This procedure is done in an operation theatre with full preparation for resuscitative measures to deal with re ...
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