Ozljeda zuba pri endotrahealnoj intubaciji

master's thesis

• Title (english): Tooth injury during endotracheal intubation
• Author: Ana Družijanić
• Mentor: Miroslav Bekavac-Bešlin (mentor)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2006, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Endotrahelna intubacija jest postupak postavljanja tubusa direktno u traheju radi osiguranja dišnog puta. Koristi se u svakodnevnoj bolničkoj praksi prilikom zahvata u općoj anesteziji, u tijeku liječenja pacijenata na JIL-u te zbrinjavanja hitnih apnoičnih pacijenata. Izvodi se pomoću laringoskopa sa ravnom ili zakrivljenom špatulom, endotrahelanog tubusa, stileta-vodilice za tubus te ostalih pomoćnih sredstava za fiksaciju postavljenog tubusa. Može biti nazotrahealna ili orotrahealna. Nazotrahealna intubacija se provodi kroz nosnu šupljinu do orofarinksa, a zatim pomoću Magillovih hvataljki i laringoskopa u traheju. Preferira se kod traume vratne kralježnice, teških ozljeda usne šupljine i pacijenata s trizmusom. Kontraindicirana je kod hitnih stanja, pacijenata s frakturom kostiju srednjeg lica i baze lubanje. Orotrahealna intubacija se provodi kroz usnu šupljinu pomoću laringoskopa. Tubus se pomoću laringoskopa aplicira kroz larinks i glasnice do račvišta traheje. Kao i svaki zahvat tako i ETI nosi komplikacije koje uz znanje i iskustvo liječnika ovisi i o stanju pacijenta. Neke od njih mogu vitalno ugroziti pacijenta uzrokujući hipoksiju mozga i smrt kao npr. neuspjela intubacija, intubacija jednjaka ili bronha, dok druge nisu kobne ali mogu produljiti oporavak bolesnika kao npr. trauma oralnog tkiva i zubi. Da bi se spriječile ozljede zubi, potrebno je prije operacijskog zahvata, odnosno same intubacije, barem vizualnom inspekcijom uvidjeti stanje usne šupline pacijenta. Visokorizični pacijenti (pacijenti s parodontnom bolesti, s ograničenim otvaranjem usta ili malokluzijom) zahtijevaju detaljniju obradu.

Abstract (english)

The endotracheal intubation is a procedure of placement the tube directly into the trachea to insure the airway. It is used in everyday`s hospital practice during intervention under general anesthesia, recovering on Intesive Care Unit or in emergency providing for apnoic patients. It is performed by a laryngoscope with straight or curved blades, endotracheal tube, stilets- conductor for the tube and the other accessories for fixation of a positioned tube. The intubation can be nasotracheal or orotracheal. The nasotracheal intubation is performed via nasal cavity till oropharynx, and then with Magill`s clamps and the laryngoscope into the trachea. It is prefered in present of the C spine trauma, serious injuries of oral cavity and patients with trismus. It is contraindicated during emergency in apnoic patients, and when a severe mid-facial fracture and basilar fracture exist, too. The orotracheal intubation is performed via oral cavity by laryngoscope. The tube is with laryngoscope placed, through the larynx and vocal cords to the bifurcation trachea. As the other procedure ETI can cause complications which depend on knowleage and expiriance of the physician and also on the condition of the patient. Some of them can be life threatening causing hypoxic brain damage or death, like for example: faild intubation or oesophageal or bronchial intubation. Some of them are not letal, but can prolonge recovering like teeth trauma or oral tissue trauma. To prevent teeth trauma it is necessery before surgical procedure, and intubation itself, assess at least by visual inspection the condition of oral cavity. The high risk patients (patients with periodontal disease, limited mouth opening or malocclusion) require detail examination.

• Keywords: endotrahealna intubacija
• Keywords (english): Endotracheal intubation
• Language: croatian
• URN:NBN: urn:nbn:hr:127:638222
• Study programme: Title: Integrated undergraduate and graduate university study of Dental Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor dentalne medicine (doktor dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Closed access
• Created on: 2024-08-30 10:11:13