By Pat Sullivan
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Additional info for Anaesthesia for Medical Students
There are, however, numerous reports of physicians auscultating "distant breath sounds" in each lung field, when the ETT was, in fact, incorrectly placed in the esophagus. Hence, listening to the V: +* Must Know 6 Intubation and Anatomy of the Airway lung fields may reveal bronchospasm or evidence of an endobronchial intubation, but cannot be relied on as absolute proof that the tube is correctly positioned in the trachea. If the tube is positioned in the tracheal lumen and the patient is breathing spontaneously, the reservoir bag will fill and empty with respiration.
The two most common anaesthesia circuits used for adult anaesthesia are the circle circuit and the Bain circuit. An anaesthesia circuit functions to take the anaesthetic gases from the machine to and from the patient. The circle circuit contains a soda lime canister to absorb the exhaled carbon dioxide, an inspiratory and expiratory valve to direct the flow of gases, and light weight corrugated tubing to transport the gases. A sample port near the patient end of the circuit is used for analysis of the respiratory gases.
This, you suggest, probably represents his optimal blood gas values. e. < 10 mm Hg) pulsus paradoxus. You also note that the patient is able to talk without stopping frequently to catch his breath, and that he is not vigorously using his accessory muscles of respiration. Reviewing his other lab tests you note a Hb = 170, WBC = 12,000, and an ECG which is unchanged from his former cardiogram. The CXR demonstrates hyperinflation with basal bullae, but gives no evidence of cardiac failure or pulmonary infection.
Anaesthesia for Medical Students by Pat Sullivan