Name: 瞭解氣管造口管：醫療專業人員必備指南 (Understanding Tracheostomy Tubes: Essential Guide for Medical Professionals)
Uploaded: 2025-04-24T04:59:28.000Z
Duration: 9 min 35 s

We're going to go over the different parts of the actual device of the tracheostomy.

我們將介紹氣管造口實際裝置的不同部分。

轉承詞

First we're going to start with what you see when you look at the patient because the whole tracheostomy won't be visible to you.

首先，我們將從觀察病人時所看到的情況開始，因為整個氣管造口不會被你看到。

情態副詞

You'll only be able to see the name plate, the end plate here, and whether or not there's a pilot balloon.

你只能看到這裡的銘牌和尾牌，以及是否有引航氣球。

So when you walk into a room, that's the portion that you'll be able to see.

是以，當你走進房間時，你能看到的就是這一部分。

The plate itself has important information on it, such as what type of tracheostomy it is.

標牌上有重要資訊，如氣管切開術的類型。

It also tells you the size of the tracheostomy.

它還會告訴您氣管造口的大小。

This is a six, and then it says FEN, so fenestrated, meaning there's a hole in the back of the tracheostomy.

這是 6 號，然後寫著 FEN，所以是 fenestrated，意思是氣管造口後面有個洞。

So you can gain a lot of information and knowledge about the tracheostomy by looking at the plate.

是以，通過觀察平板，您可以獲得很多有關氣管切開術的資訊和知識。

This is also what attaches to the neckties.

So these neckties go through the holes on either side of the plate and are how you attach the tracheostomy to the patient's neck.

這些頸圈穿過鋼板兩側的孔，將氣管造口固定在患者頸部。

The pilot balloon itself is also important to recognize because if there's a pilot balloon, you know that there's a cuff on the trach and that the trach itself can be used in an emergent situation as an airway and that you will be able to completely control the airflow by inflating the cuff versus a tracheostomy that does not have a cuff.

先導氣球本身也很重要，因為如果有一個先導氣球，您就知道氣管上有一個充氣罩囊，而且氣管本身可以在緊急情況下用作氣道，與沒有充氣罩囊的氣管切開術相比，您可以通過給充氣罩囊充氣來完全控制氣流。

There's no pilot balloon, as you can see.

正如你所看到的，沒有氣球飛行員。

So you know that this cannot be used in an emergent situation as an emergent airway.

是以，在緊急情況下不能將其用作緊急氣道。

Now we're going to go over how to tell if the cuff is inflated versus deflated.

現在我們來看看如何判斷袖帶是否充氣或放氣。

You're going to be able to tell that by simply looking at the pilot balloon.

Here the pilot balloon is deflated, so is the cuff.

在這裡，先導氣球被放氣，袖帶也是如此。

I'll show you what it looks like when it's inflated.

So the cuff is now inflated and so is the pilot balloon.

是以，袖帶現在已經充氣，先導氣球也是如此。

You won't be able to see the cuff because that's going to be in the patient in the airway, but you'll be able to see the pilot balloon and know that it's inflated.

您無法看到充氣罩囊，因為它在患者的氣道中，但您可以看到引導氣球，知道它已經充氣。

Now we're going to talk about the outer cannula and the differences between the outer cannulas and why those differences are important to understand and know.

現在我們來談談外套管和外套管之間的區別，以及為什麼要了解和認識這些區別。

This part of the device is called the outer cannula and is what fits into the airway.

設備的這一部分稱為外套管，是與氣道相吻合的部分。

It can either be fenestrated, meaning there's a hole in the back, or it can be unfenestrated, like this tracheostomy.

它既可以是有孔的，也可以是無孔的，比如這個氣管造口術。

Here you can see there's no hole in the back.

在這裡，你可以看到後面沒有洞。

And that's important to know because air flows through the fenestration when there's a hole, and obviously air doesn't flow through if there's no hole, meaning that with this tracheostomy, air can only go in and out and it won't go up past the vocal cords and through the patient's mouth when they exhale if there's no fenestration.

這一點很重要，因為如果有孔，空氣就會流經柵欄，如果沒有孔，空氣顯然就不會流經柵欄，也就是說，如果沒有柵欄，氣管造口術後，空氣只能進不能出，呼氣時也不會經過聲帶和病人的口腔。

The outer cannula does not connect to the ambu bag.

We'll go over more later why that's important, but the inner cannula, which we'll go over now, is the portion that connects to the ambu bag.

我們稍後會詳細說明這一點的重要性，但我們現在要介紹的內插管是連接救護包的部分。

There's different mechanisms for removing the inner cannula, and it's important to become and sometimes it can be a little tricky, but it's important to understand how to remove the inner cannula because sometimes it can become occluded with secretions and you need to be able to remove it to either replace it with a new one or you can clean the inner cannula.

移除內插管有不同的機制，這一點很重要，有時可能有點棘手，但瞭解如何移除內插管很重要，因為有時內插管會被分泌物堵塞，您需要能夠移除內插管，以便更換新插管或清潔內插管。

But this allows, this makes it so that you don't always have to replace the entire device, you can just replace the inner cannula itself.

但這樣一來，就不必總是更換整個裝置，只需更換內套管即可。

So I'll show you a different type of inner cannula mechanism for connecting with the tracheostomy.

是以，我將向你們展示一種不同類型的內插管裝置，用於連接氣管造口。

This one twists and clicks in, and then to take it out you twist and remove it as well, and you can feel when you put it in that it clicks in so you know that it's not fenestrated.

當你把它放進去時，你可以感覺到它是卡在裡面的，這樣你就知道它不是柵欄式的。

So for example, in this trach, if I put this inner cannula in and it doesn't have a fenestration, then I'm still completely controlling the airflow through the airway and none of it is escaping through the back of the fenestration of the trach because there's no fenestration in the inner cannula.

例如，在這個氣管中，如果我將這個內套管放進去，但它沒有柵欄，那麼我仍然可以完全控制氣道中的氣流，沒有任何氣流會從氣管柵欄的後面漏出，因為內套管中沒有柵欄。

Versus this inner cannula, you can see it's different.

與這個內套管相比，你可以看到它是不同的。

It's green, so the different colored cap is how you know that it's different from the original inner cannula, and it has a fenestration on the back.

它是綠色的，所以通過不同顏色的蓋子可以看出它與原來的內插管不同，而且背面有一個柵欄。

So it clicks in the same way, but now that fenestration is open, which allows for air if the cuff is deflated.

是以，它以同樣的方式點擊，但現在柵欄是打開的，如果袖帶放氣，就可以通氣。

Allows for air to travel up through the trach, around the trach, to the patient's vocal cords and out their mouth.

讓空氣通過氣管向上流動，繞過氣管，到達病人的聲帶，然後從他們的口中排出。

Now we're going to talk about the obturator and why it's important to know what it is and in what situations it's used.

現在我們來談談閉孔器，以及為什麼要知道它是什麼，在什麼情況下使用。

It goes into the tracheostomy instead of the inner cannula, so it will not fit into the trach if you have an inner cannula in the trach.

它進入的是氣管造口，而不是內插管，是以，如果您的氣管內有內插管，它就無法進入氣管。

You can see that it has a rounded edge and it's rigid in shape.

你可以看到，它的邊緣是圓的，形狀很硬。

You're going to use the obturator in situations where you're having to put a new tracheostomy into a patient.

在為病人安裝新的氣管造口時，您需要使用閉塞器。

It provides a rigid shape, so it allows you to maintain the tracheostomy as you put it into a patient.

它具有堅硬的形狀，是以在為病人置入氣管造口時可以保持氣管造口。

It also has the rounded edge, so as you're putting the new tracheostomy into the patient, you're protecting the airway from damage from the sharp edge of the tracheostomy itself, because as you can see, without the obturator, there's a sharp edge here.

它的邊緣也是圓形的，是以在將新的氣管造口放入病人體內時，可以保護氣道免受氣管造口本身鋒利邊緣的損傷，因為如你所見，如果沒有閉孔器，這裡就會有一個鋒利的邊緣。

Lastly, we're going to talk about the different types of caps and how they help you airflow in and out of the tracheostomy and allow for patients to start talking on their own again and using their vocal cords and gaining their cough reflex.

最後，我們將介紹不同類型的管帽，以及它們如何幫助氣流進出氣管造口，讓患者重新開始自主說話、使用聲帶並獲得咳嗽反射。

I'm going to put the inner cannula back into this tracheostomy and it clicks in there.

我要把內插管插回氣管造口，然後卡在那裡。

It's a one-way valve, so it attaches to the inner cannula here and it allows for air to go into the tracheostomy but not out.

這是一個單向閥，可以連接到這裡的內套管上，允許空氣進入氣管造口，但不能排出。

You actually wouldn't want to use this on a trach that doesn't have a fenestration.

實際上，你不會想在沒有柵欄的氣管上使用這個。

You're only going to use it on a tracheostomy that does have a fenestration.

只有在氣管造口有開口的情況下才能使用。

See, I'm putting the inner cannula with a fenestration in, clicking it in, and then attaching the Passy-Muir valve.

看，我把帶有柵欄的內套管放進去，咔嚓一聲，然後裝上 Passy-Muir 瓣膜。

It's allowing for air to go into the tracheostomy, but it won't allow air back out.

它允許空氣進入氣管造口，但卻不允許空氣返回。

That means that as the patient exhales and air goes this way around the trach that is with a cuff that's deflated, all of it will be forced to go through the fenestration and past the patient's vocal cords so that they can talk.

這就意味著，當病人呼氣時，空氣會沿著帶有放氣袖帶的氣管流向這邊，所有的空氣都會被迫通過氣孔，經過病人的聲帶，這樣他們就可以說話了。

It doesn't allow any of the air to escape back out of the tracheostomy.

它不會讓任何空氣從氣管造口中排出。

Once they've been able to tolerate having a Passy-Muir valve on for an extended period of time without desaturating, you know that they're ready to advance to the next level of potentially breathing on their own completely, which means that you're going to cap the tracheostomy itself.

一旦他們能夠忍受長時間佩戴 Passy-Muir 瓣膜而不出現不飽和現象，你就知道他們已經準備好進入下一個階段，即完全自主呼吸，這意味著你將為氣管造口本身加蓋。

This is a different type of inner cannula, but it doesn't allow any air in or out of the tracheostomy.

這是一種不同類型的內插管，但它不允許任何空氣進出氣管造口。

If you see this, you know that there's no air going in or out of the tracheostomy and the patient is breathing completely on their own because this is just a cap and those are the different parts and types of tracheostomies. you

如果你看到這個，你就知道氣管造口沒有空氣進出，病人完全靠自己呼吸，因為這只是一個蓋子，這就是氣管造口的不同部位和類型。