Review Note
Last Update: 02/17/2025 02:45 AM
Current Deck: ACG Part 2::Thoracic SSU
New Card (Unpublished)Currently Published Content
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Front
Commit #284678
SS_TS 1.9 Describe the different methods available to perform lung isolation including the use of double-lumen tubes, bronchial blockers, single lumen tubes and Univent tubes and the rationale for selecting different methods in different situations (refer to the Paediatric anaesthesia specialised study unit for issues specifically pertaining to paediatric patients) :
- Double lumen tubes
- Double lumen tubes
Back
Commit #284678
- Most common approach
- Right or left depending on main bronchus intubated
- Left sided tubes used most commonly (straight path of L main bronchus cf. right)
- If right sided tube used, has Murphy’s eye for RUL ventilation
- Sizes equivalent to external circumference in mm (French guage). Size differs with manufacturer. Lumens are smaller than SLTs (eg. 39Fr lumen = 6.0mm)
- Sizing: 41Fr for large stature males, 39Fr for normal stature males, 37Fr for normal stature females, 35Fr for short stature females
Steps for insertion
- Selection of appropriate size
- Preloaded with stylet, tip directly anteriorly, pass tip just through vocal cords
- Remove stylet
- Rotate tip 90 degrees from midline (anticlockwise with left sided DLT)
- Advance tube until snug or at approx 29cm at teeth, depth of insertion in a 170 cm adult is 29 cm, plus or minus 1 cm for each 10 cm increase or decrease in height
- Tracheal cuff up; ensure ETCO2 back as per usual
- Cuff pressure expected 20-40cmH20
- Fibreoptic down tracheal lumen to check position