A Milton sterilising solution may also be used ( requiring at least 15 minutes ); other sterilising solutions should be used according to the manufacturers ' directions . ETTs cannot be cleaned with , or come into contact with , a chlorhexidine solution , as this is an irritant to mucous membranes and can cause tracheal irritation ( Murrell & Ford-Fennah , 2020 ).
The ETT should then be thoroughly rinsed , including the lumen , and the outside dried with paper towel . Shaking the tube may remove some water from the inside and it should then be placed on a rack to continue to dry . Finally , the cuff should be deflated and the ETT stored on the appropriate rack , ready for use ( Figure 12 ).
REFERENCES
Bradley , C . ( 2015 ) Keeping an eye on the target , Sterilizing practice for veterinary nurses . The New Zealand Veterinary Nurse . 74 ( 21 ), 6 – 19 . Available from : https :// www . nzvna . org . nz / site / nzvna / files / articles / Sterilisation . pdf [ Accessed 5 October 2021 ].
Dugdale , A . H ., Beaumont , G ., Bradbrook , C . & Gurney , M . ( 2020 ) Veterinary Anaesthesia Principles to Practice . 2nd ed . Oxford , Wiley-Blackwell , pp 160 – 164 .
Hughes , L . ( 2016 ) Breathing systems and ancillary equipment . In : Duke- Novakovski , T ., de Vries , M . & Seymour , C . ( eds .) BSAVA Manual of Canine and Feline Anaesthesia . 3rd ed . Gloucester , BSAVA Publications , pp . 56 – 58 .
Mosley , C . A . ( 2015 ) Anesthesia equipment . In : Grimm , K . A ., Lamont , L . A ., Tranquilli , W . J ., Greene , S . A . & Robertson , S . A . ( eds .) Veterinary Anaesthesia and Analgesia . 5th ed . Oxford , Wiley-Blackwell , p . 24 .
Murrell , J . & Ford-Fennah , V . ( 2020 ) Anesthesia and analgesia . In : Cooper , B ., Mullineaux , E . & Turner , L . ( eds .) BSAVA Textbook of Veterinary Nursing . 6th ed . Gloucester , BSAVA Publications , pp . 695 – 697 .
Phillips , H . ( 2018 ) Endotracheal Intubation – Yes , Veterinary Nurses can learn it too . Australian College of Veterinary Nursing . Available from : https :// vetnurse . com . au / 2018 / 03 / 07 / endotracheal-intubation / [ Accessed 5 October 2021 ].
Tear , M . ( 2012 ) Endotracheal intubation . In : Small Animal Surgical Nursing Skills and Concepts . 2nd ed . St . Louis , Elsevier Mosby , pp . 60 – 65 .
Learning reflection
1 . What reaction are cats susceptible to when intubating ?
Figure 12 . Store ETTs in a rack ready for use . a ) b )
Spasm of the epiglottis Spasm of the trachea
Conclusion
Endotracheal intubation is a skill all trainee nurses and VNs should practise and be able to perform . An understanding of the anatomy involved and the correct technique is essential , and careful monitoring of the tube during anaesthesia should be employed . c ) d )
Spasm of the larynx Spasm of the bronchus
2 . When using a manometer , to inflate an endotracheal tube cuff , what level of pressure is appropriate to ensure an adequate seal ?
After use , the cleaning of the ETT is a task commonly carried out multiple times a day but it should not be done with complacency . After all , the ETT is a lifeline and paramount in the delivery of O 2 and volatile anaesthetic to the patient .
All ETTs should be properly checked prior to use , and always cleaned appropriately . It should be remembered that not following the correct protocol for cleaning ETTs can put our patients ' lives at risk . a ) b ) c ) d )
15cm H 2 O
20cm H 2 O
25cm H 2 O
30cm H 2 O
Answers 1 . c 2 . c
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