- Sécurité de la nutrition entérale
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Respirant
- Tube à oxygène nasal
- Masque à oxygène
- Masque de diagramme de capacité
- Masque non respiratoire
- Couverture intérieure de wenqiu
- Masque Multi - ventilation
- Masque d'atomiseur
- Plaque de port avec atomiseur
- Masque de trachéostomie
- Kit de soufflage et de filtration ABC
- Exercice respiratoire volumétrique
- Respirateur d'excitation
- Exercice respiratoire
- Contrôle du mucus de la soupape de vide
- Cathéter d'aspiration
- Clamp d'échantillon de mucus
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Conduit d'aspiration fermé
- Cathéter d'aspiration fermé à double rotation de type B 24 heures sur 24
- 24 heures B Trach t Seal aspiration Duct
- 24 heures PEDI y connecteur conduit d'aspiration fermé
- Tube d'aspiration à double rotation fermé de type 72H K
- 72H K Trach t - seal Suction Duct
- Disposable closed suction catheter - 翻译中...
- Extracteur de mucus
- Extracteur de mucus avec gaine de protection
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Gestion des voies respiratoires
- Voies respiratoires oropharyngées
- Voies respiratoires nasopharyngées
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Voies respiratoires du masque laryngé
- Masque laryngé en PVC standard
- Amélioration des voies respiratoires du masque laryngé en PVC
- Voies respiratoires en PVC de 90 degrés
- Masque laryngé en silicone standard
- Masque laryngé en silicone renforcé
- Voies respiratoires réutilisables
- Voies respiratoires réutilisables avec masque laryngé renforcé
- Intubation trachéale
- Trachéostomie
- Aiguille d’intubation
- Intubateur trachéal
- Anesthésie
- Laparoscopie
- Chirurgie cardiothoracique
- Procédures de soins endoscopiques et accessoires
- Gynécologie
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Chirurgie d'attraction
- Flexi Clear yankauer Handle
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Poignée yankel
- Yankauer plat
- Bride yankauer
- Pointe conique yankauer
- On / off yankauer with flat end
- On / off yankauer With Conical Tip
- Bulbe APEX yankel
- Pointe de la Couronne
- Pince élastique
- Tige d'aspiration rigide
- Poignée d'aspiration de Poole visible aux rayons X
- Yankauer à deux pièces
- Bec de canard
- Poole Suction Handle - 翻译中...
- Sonde d'aspiration
- Aspirateur orthopédique
- Tube d'aspiration ORL
- Tank yankel
- Yankauer orthopédique
- Extrémité chirurgicale de l'aspirateur
- Paille Fraser
- Paille jetable
- Tuyau d'aspiration
- Revêtement souple du réservoir d'aspiration
- Bidon d'aspiration avec kit de filtre
- Réservoir d'aspiration rigide
- Réservoir extérieur réutilisable
- Ligateur d'hémorroïdes
- Connecteur
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Urologie
-
Lave - vessie
- Lave - vessie m - Easy
- Lave - vessie B - cylindre
- Lave - vessie
- Lave - vessie S - Uni
- Rinçage urinaire de la vessie
- Lave - vessie plemi
- J pompe de lavage de la vessie
- J - Tur Bladder Washer
- Rinçage de la vessie par pompe H
- Lave - vessie à débit sup
- Maple Irrigation Set - 翻译中...
- Peony Irrigation Set - 翻译中...
- Rinçage arthroscopique
- Sac de drainage urinaire
- Sac de drainage urinaire
- Appareils de bain
- Sac lavement
- Cliquez sur sceller le contenant de l'échantillon
- Sac de drainage par aspiration / sac de drainage urologique
- Cathéter nellaton
- Conduits et raccords de douilles
- Cathéter mâle en silicium
- Ensemble d'irrigation en bois de santal
- Ensemble d'irrigation Freesia
- Ensemble d'irrigation jonquille
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Lave - vessie
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Chirurgie générale
- Doublure / rideau de bassin
- Tube de puisard gastrique
- Dispositif d’administration du sang
- Capsule d’héparine
- Capuchon de protection
- Applicateur
- Manchon de mélange
- Dispositif de décantation
- Tee plug
- Couvercle de la poignée lumineuse
- Adaptateur métallique pour couvercle de poignée de lampe
- Seringue de rinçage à billes
- Seringue auriculaire / ulcère
- Couverture de l'objectif
- Rideau magnétique
- Fixateur chirurgical à main
- Distributeur de sacs de vomissement
- Sac de vomissement
- Brosses médicales
- Barre d'éponge
- Dispositif d'atomisation muqueuse
- Rinçage dentaire
- Compteur d’aiguilles
- Capuchon de rinçage
- Pince nasale
- Tube d'étalonnage jetable
- Seringue d'irrigation Toomey
- Seringue d'irrigation dentaire
- Seringue d'irrigation à bulbe de 100 ml
- Marqueur scléral
- Matériel médical durable
- Équipement de protection individuelle
- Produits et accessoires laparoscopiques
- Produits COVID-19
- Dispositif médical SANS PVC
Analgésie Tranquillisée Technique d'Intubation Endotrachéale Nasale
Clinical experience has shown that nasal endotracheal intubation is often used for patients who have difficulty with oral intubation, need to maintain tracheal intubation post-surgery or require clinical treatment of the oropharynx. This article mainly discusses the use of sedation and analgesia for nasal endotracheal intubation.
Classification of nasal endotracheal intubation
Nasal endotracheal intubation is clinically classified as either visual or blind insertion techniques. Visual insertion is divided into complete visual intubation and partial visual intubation. Complete visual intubation is typically performed using a bronchoscope for guidance throughout the alignment of the insertion. Partial visual intubation typically entails blindly inserting a guide wire through the nasal cavity and into the pharynx followed by exposing the vocal cords via an endoscope and placing the tube into the trachea. The choice between techniques typically hinges on the patient's needs and conditions, as advised by the attending physician. Endotracheal tube suppliers must remain vigilant, ensuring that healthcare facilities have access to the appropriate tubes required for nasal endotracheal intubation.
All three types of nasal endotracheal intubation require adequate sedation and analgesia. Bronchoscope-guided intubation also requires the use of drugs to inhibit airway secretions, such as atropine or glycopyrrolate. The other two nasal endotracheal intubation techniques do not have particularly high demands on the removal of airway secretions, although the bronchoscope-guided intubation requires slightly higher skills in operation.
Anesthesia and operation for nasal endotracheal intubation
During anesthesia and operations involving nasal endotracheal intubation, the utilization of a disposable endotracheal tube can help ensure patient safety. After the patient enters the operating room, they are typically asked to extend their tongue out, after which 2-3ml of 2% lidocaine is sprayed along the whole tongue surface naturally flowing into the tongue root pharynx. The patient is then instructed to hold the anesthetic in his throat for about 5 minutes before swallowing. Then, intravenous sufentanil 10-20ug is administered, followed by an infusion of dexmedetomidine at a loading dose of 0.4ug/kg for 5-10 minutes. Small doses of remifentanil can also be infused simultaneously until intubation is complete. For bronchoscope-guided intubation, atropine or glycopyrrolate (0.01mg/kg) is also given through an intravenous infusion. After the patient swallows the lidocaine, 2-3ml of 2% lidocaine is injected into the vocal cords through the laryngoscope or is injected via puncture through the cricothyroid membrane. The latter is more effective. At this point, episodic sedation prior to nasal endotracheal intubation was essentially complete.
After removing the nasal swabs, any phlegm in the oropharynx is initially removed. For bronchoscope-guided intubation, the scope is inserted deep into the lower nostril and gradually enters the trachea via the middle of the airway. For the other two methods, the catheter is inserted through an adult suction tube, and the catheter is inserted through the nasal cavity. If there is any resistance while inserting the catheter, it can be slowly rotated to place it through the narrow passages both anteriorly and posteriorly, and then placed into the pharynx.
After the tip of the catheter enters the pharynx, the vocal cords are exposed by inserting the laryngoscope through the mouth, and the catheter can be visually placed into the trachea via the catheter-guided pouch, or with the aid of a catheter clamp.
In conclusion, the above-mentioned intubation techniques can be selected depending on the patient's condition, the surgical situation, personal experience, equipment, medication and personnel available in the department.
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