1 / 26

EZ-Blocker ®

EZ-Blocker ®. Jan. 2010. EZ-Blocker ®. A bronchoscope is mandatory Bronchoscopic control for all in-, and deflations. EZ-Blocker ®. ETT Endotracheal tube EZB EZ-Blocker ® DLT Double Lumen Tube MPA Multiport Adaptor. Preparations. Preparations. Sterile cloth ETT

loc
Download Presentation

EZ-Blocker ®

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. EZ-Blocker® Jan. 2010

  2. EZ-Blocker® • A bronchoscope is mandatory • Bronchoscopic control for all in-, and deflations

  3. EZ-Blocker® • ETT Endotracheal tube • EZB EZ-Blocker® • DLT Double Lumen Tube • MPA Multiport Adaptor

  4. Preparations

  5. Preparations • Sterile cloth • ETT • Lubricant • Syringe • Marker • EZ-Blocker® set • EZB • Multiport Adaptor • Closing caps • CPAP connection piece

  6. Preparations • Inspect for damage • Remove protection shaft of the EZB carefully by pulling the label at the top of the shaft Fix 2 blue closing caps on CPAP ports • Inflate cuffs to check for leakage • Deflate completely  vacuum • Lubricate

  7. Preparations (*)

  8. Preparations • Compare the lengths of EZB withETT plus MPA,place mark on the proximal shaft or remember distance in cm’s • The EZB should wedge on the carina within 8 cm from this mark (*). 4 cm towards the carina and 4 cm to wedge upon the carina

  9. Intubation

  10. Intubation • ETT cuff directly behind the vocal cords • ETT tip to carina at least 4 cm • Connect MPA to ETT and start ventilating through MPA Approx. 100% O2

  11. Intubation EZBextensions need 4 cm to spread before wedging the carina Distal end ETT 4 cm Carina

  12. EZB placement (*)

  13. EZB placement • First action after intubation  Check by bronchoscope for abnormalities in anatomy • Confirm: depth of ETT (4 cm to carina) • Insert EZB through MPA • Check under vision closing main stem bronchus and/or RUL -> if necessary manipulate cuff in right position

  14. EZB placement • Fiberscopic inspection of cuffs • Inflate the cuff in thetarget bronchus until Minimum Occlusive Volume (MOV) has been reached • Deflate the cuff  vacuum

  15. EZB Procedurelung collapse • Ventilate with deflated cuffs. Approx. 100% O2 • Position the patient • Disconnect ventilation from MPA as soon as the surgeon enters the thoracic cavity • Lung will collapse

  16. EZB Procedurelung collapse • If needed, the surgeon manipulates the lung to the size of his desire • After successful collapse, the cuff is inflated under vision, start One Lung Ventilation • Through resorption lung collapse will improve • If collapsed lung starts ventilating again, deflate cuff and disconnect ventilation -> re-collapse! • When lung has the right size -> re-inflate cuff and restart ventilation -> Always check with scope!

  17. EZB removal • End of operation  deflate cuff. Vacuum! • Ventilate carefully to remove all atelectases • Block the other lung for bi-lateral procedure, or remove the EZB • The same ETT is used postoperatively

  18. Essentials

  19. Essentials • ETT cuff must be introduced directly behind the vocal cords

  20. Essentials First action after intubation  Bronchoscopy Confirm: Depth of ETT (4 cm from carina) and location of right upper lobe If a cuff is not inflated, it should be deflated completely (vacuum) Both cuffs should never be inflated at the same time  †

  21. Essentials • After the EZB extends from the ETT, the EZB will wedge on the carina within ± 8 cm • After wedging the EZB on the carina, the ETT may be advanced a few cm for even more stability • No wedge?  Both extensions situated in the same bronchus  Check with scope, retry and/or withdraw ETT for a few cm to provide space for spreading

  22. Essentials ALWAYS withdraw your scope first After that remove the EZ-Blocker NEVER withdraw the EZ-Blocker first

  23. Essentials • Deflate cuffs completely (vacuum) • Carefully ventilate until all atelectases are gone • PEEP is needed before wound closure • Check lung expansion • Remove Bronchoscope first, then the EZB • Never jet-ventilate a patient with a EZB in place -> The lung could be damaged

More Related