What are the various pipes and wires on the bed, what are they? Where is it from? Location right?

First, tracheal intubation

The tracheal intubation refers to the nasal cavity in the nasal cavity in the nasal cavity, and the mouth is inserted into the trachea, which maintains a smooth airway, ventilation oxygen, prevents miscology.

Normal position: The end of the tracheal intubation is located between the level of the clavicle and T4, which corresponds to the 5 cm position of the ridge, and the end is erroneous due to the fold, but no more than 2 cm above.

abnormal situation:

1. The tracheal wall should not have a profuncy, and if the tracheal trachea is greater than 2.8cm, there should be suspected cracking.

2, the end is located at the right bronchi, often leads to the left lungs or right tensile pneumothorax.

3, the end is located in the throat, often causes acoustic band damage, inhalation pneumonia.

Figure: Normal tracheal intubation, yellow arrow - tracheal intubation end; green arrow - trachea

Figure: The end of the tracheal intubation enters the right bronchial (red arrow), the left and left lungs in the right lung.

Second, the tracheal cutting sleeve

Tracheal tube is cut into a neck trachea, placed in a metal tracheal sleeve to relieve the dyspnea of ​​the throat, and the breathing machine can be disordered or the lower respiratory tract secretion is difficult.

Normal position: The end of the sleeve is between the cut and the tracheal rushes, which is equivalent to the T3 level, and the insertion width is equivalent to 2/3 of the trachea diameter.

Abnormal conditions: Soclasceral accompanied by the lateral cockroaches near the late stage.

Figure: Normal tracheal cut surgery after tracheal intubation, Blue Arrow - Cutting, Yellow Arrow - Torrel Terminal; Green Arrow - Tracheral Straight.

Third, the central venous tube

The central venous catheter is inserted from the osteogeneous vein to the upper venous vein ratio, for rapid rehydration and measurement center venous pressure.

Normal position: The intersection of the illegal vein and the head arm vein is in the inner section of the clavicle, the central vein tube should be turned down here, walk along the right side of the spine, and the end is within the upper vena cava (equivalent to T5 .

abnormal situation:

1. The most common error position is inserted into the right atrium or intravenous vein, causing arrhythmia, or the central venous pressure detection is not accurate.

2, the end wear the blood vessel wall, often visible the end folded curved.

3, inserted into the artery.

Figure: Yellow arrow - the normal position of the end of the central vein tube.

Figure: Central venous tube folds back (red arrow) in the right chain.

Fourth, PICC tube

The PICC tube is entirely called the peripheral vein to enter the central venous tube, and the tip of the catheter is placed in the upper intravenous intravenous vein in the outer peripheral intravenous vein, head vein, elbow, intravenous vein, equal intravenous vein, etc. The central venous catheter is mainly used for long-term replenishment.

Normal position: located in the upper vein, the same as the center venous tube.

Abnormal situation: Long-term placement is easy to displacement.

Five, pulmonary artery floating catheter

Also known as the SWAN-GANZ catheter, the Swan-GaNZ catheter is inserted into the velocity vena cava or the lower cavity, and is placed in the left or right veins of the left or right venom. It is used to evaluate the blood flow kinetic state of the patient, which helps identify cardiogenic pulmonary edema and non-cardiocylmon edema.

Normal position: located in the left / right pulmonary artery, about 2cm from the lung door.

Abnormal situation: Pulmonary infarction, arrhythmia  Pulmonary perforation, catheter is folded in the cavity, knotted.

Figure: Implantation of pulmonary artery floating catheter, yellow arrow - catheter end.

Figure: The pulmonary floating catheter is folded back (red arrow) in the left pulmonary artery, and the end enters the right ventricle (green arrow).

Figure: The pulmonary floating catheter enters the distal end of the right pulmonary artery (red arrow).

Six, chest drainage tube

It is widely used in pneumothorax and pleural effusion.

Normal position: The end of the pneumothorax is generally in front of the chest, the end of the pleural effusion is generally in the rear chest, and any one sidehole should not exceed the ranging of the chest wall.

Abnormal situation: damage to the intercostatic artery caused a large bleeding, puncture causes liver, spleen damage, pneumothorax, pulmonary contusion, recipient pulmonary edema.

Figure: Right pneumothorax, chest drainage tube, yellow arrow - drainage tube end is located in the upper right chest, blue arrow - side holes located in the chest wall.

Figure: The chest drainage tube passes through the mediastation into the left chest (red arrow).

Seven, heart pacemaker

The electrical pulse of the battery is issued by the pulse generator, and the heart muscle contacts the electrode through the conduction of the wire electrode, the heart is excited and contracted, thereby achieving the purpose of treating heart dysfunction caused by certain arrhythmia.

Normal position: The end of the normal electrode wire is located in the right ventricle, close to the chamber wall, may have mild curved, but not sharp bends. Partial lug electrode wires can be located in the right heart or coronary.

Abnormal situation: The broken electrode wire can enter intravenously, or puncture the heart.

Figure: Red circle - bipolar pacemaker, Green Arrow - Right Room Electrode, Red Arrow - Right Cereal Electrode

Eight, implanted heart rhythm transmissil (ICD)

ICD has the role of supportive pacing and anti-anti-automatic pacing, low energy heart transparency and high energy defibrillation, can recognize the fast ventricular arrhythmia of patients in a few seconds and automatically discharge defibrillation, significantly reduced The incidence of sudden death rate of malignant ventricular arrhythmia is saved.

Normal position: One electrode wire is located in the upper vena cava or head arm vein, and the other electrode wire is located in the right ventricle.

Abnormal case: electrode wires fall off or shift.

Figure: Red arrow-electrode wire, the wire is lower than the density of the cardiac pacemaker wire.

Nine, the aortic pulse Bo (IACB or IABP) is one of the mechanical auxiliary circulation methods, improves the aortic pressure, increases coronary blood supply and improve myocardial function. It has been widely used in rescue and treatment of patients with critical illness and other critically ill patients.

Normal position: The proximal end is located at the end of the left lock, and the distal end is located near the renal artery opening.

Abnormal situation: If the catheter is too close, the balloon may block the major blood vessels lead to stroke, if the balloon is too far, the effect is reduced;

It may also cause aortic dissection.

Figure: After the aortic balloon anti-mobilization, the balloon (yellow arrow) is located below 2 cm under the aortic arch (blue arrow).

Figure: Aortic pulse balloon anti-Bo installation, balloon close-end (red arrow) is lower than the aortic bow (green arrow)

Ten, stomach tube

The gastric tube is inserted from the nostril, via the pharyngeal, to reach the stomach through the esophagus, mostly used to breathe, or injecting liquid into the liquid to provide foods necessary for patients.

Normal position: The end is located in the gastric cavity, and at least 10 cm in the gastric cavity.

abnormal situation:

1, the location is abnormal: insert into the trachea, bronchi, or fold back in the esophagus.

2, perforation: It is common in the neck of the esophageal wall, or it can also be in the stomach wall.

Figure: Normal stomach tube, yellow arrow - the end of the stomach tube

11. Enteral nutrition pipe

It is a nutrient support for nutrients and other nutrients that provide metabolic needs by the gastrointestinal tract.

Normal position: It can be divided into two major categories of Helichannel front tube (gastric inner tube) and H., the latter can also be divided into duodenal internal tube and jejuno tube, and the common tube end is located in 12 fingers. Intracarda.

Complications: gastrointestinal perforation, inhalation pneumonia.

Figure: Nominal nutrient pipe, the end is located in the duodenal bowel portion (green arrow).

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