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— This article discusses 

  
  which is a
condition caused by veterinary staff that leads to tracheal damage
and tears, that cause pain and discomfort to patients.

Common causes being incorrect use of ET tubes;

— such as insufficient or inappropriate cleaning methods
— incorrect tube choice
— poor tube insertions
— over inflation of cuffs
— excessive movement of patient
— incorrect anaesthetic equipment choice i.e. undersized breathing
bags, high oxygen flow rates and closed pop off valves.
O



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— dyspnoea ( difficulty breathing)
— Coughing

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— Ñadiography
— Tracheoscopy or surgery leads to definitive diagnosis.

— Close attention in extubating post anaesthesia ensuring the ability to swallow is

regained and preventing dysphoria both which cause endotracheal trauma.

— Treatment of tears depends on severity and location of damage, pain

management being of primary importance, and emphasis on rest to promote
healing.
— Veterinary nurses play a key role in preventing complications by understanding
the problems that can arise and in correct monitoring and management of
intubated patients to ensure patient safety.
] 
 

  




á u

— which stands for the Journal of American Veterinary Medical
Association, is produced by the American Veterinary Medical
Association and is a major source with regard to this
particular article.
— The AVMA is an association that is highly regarded in the
veterinary medicine profession and this shows as it has been
in operation since 1863.
— The journal began publication in the 1880·s and since then it
has been the voice of well established veterinary practitioners
as they submit results of clinical studies and research.
— Therefore this source of information could be deemed as
being very  
 and
 

.
] 
 

  




Atlantic Coast Veterinary Conference:
— The intention of this yearly conference is to promote new
techniques in the veterinary field.

— It involves a group of veterinary professionals who are

regarded very highly in their field of work, presenting
different seminars about a wide range of advancements in
veterinary, therefore the information obtained from this
conference is of high quality and very precise.
] 




 


 
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— has been in private practice for 38 years and is owner/chief of staff

of 3 full-time service veterinary hospitals.
— He has contributed to ´Blackwells five-minute veterinary
management consultationµ which is a book that was published in
2007.
— He is a nationally recognised speaker, writer and consultant within
the veterinary profession in America.
— He has published over 250 articles on ´Veterinary Practice
Marketing and Managementµ
— He was a speaker at the 2010 Atlantic Coast Veterinary Conference,
which is only open for very knowledgeable and experienced
veterinary professionals.
— He is a memebr of PetCareTV·s Veterinary Advisory Board(VAB)
which is comprised of respected practitioners, hospital owners and
leading professsional consultants from around the world.
— Because of his involvement with a vast amount of veterinary
associations, he is a well educated and respected veterinary
professional who is definitely within capability of discussing this
topic.
]  







— -The main objective of the material is to give veterinary
professionals the essential information regarding ´iatrogenic
tracheal traumaµ in order for them to take the necessary
precautions and measures so as to avoid it from occuring in their
patients.
— -A major reason why the material was written is to give
professionals understanding of the endotracheal equipment used
e.g. tubes and to identify any drawbacks the equipment might
have.
— -The material further educates veterinary professionals on all
aspects regarding ´iatrogenic Tracheal Traumaµ, by identifying the
possible causes of it, steps that should be taken to prevent it and
possible treatment methods of the patient should tracheal trauma
occur.
 




— The author cannot be looked upon as being exceedingly biased in
the portrayal of his article.

— He only once gives his own opinion when he shows preference to

´
  for sterilising ET tubes, he thinks it is of
better standard compared to others.

— However he does state that this it is his opinion and does not try to
persuade his readers to use this individual drug or doesn·t show
prejudice towards other drugs.

— In general, the author simply provides information on the subject

of ´iatrogenic Tracheal Traumaµ without trying to persuade his
readers to believe in any particular theory or idea.
 




— However he can be looked upon as being biased with regard
to the specific sources from where he obtains his
information.

— He obtained information from the Atlantic Coast Veterinary

Conference of which he has involvement in as he presents
seminars at them.

— He also uses information from articles published by the

JAVMA, which he is also engaged in as he occasionally writes
articles for them.
à







 

— The writer doesn·t make assumptions throughout his article,

rather he uses information from his references to reinforce
any points or principles that he outlines.

— If it appears that he does make assumptions it is for a good

reason as he is stressing to the reader that an experienced
person should only carry out tracheal tube insertion on their
own as there is less risk of damaging the trachea
à

 


 




 
 

 


— [es I think this information is extremely useful in a practice
situation
— Iatrogenesis (where the patient is harmed by the veterinary
staff) causes unnecessary pain, profit loss, poor staff morale
and the client may lose trust in the practice.
— It may also mean further invasive and painful procedures to
an already ill animal.
r

    
 





@ 
  

  
  

— Too large an ET tube ( causing damage to the cartilage)

— Too small a tube (needs to much cuff inflation)
— Stylets that protrude past the ET tube while incubation
occurs
— Placement of ET tube past tracheal bifurcation
— Inflated cuff extubation
— Incorrect patient handling while incubated
— Incorrect disinfection of the ET tube (leading to perhaps
chemical burns in the next patient)
@
   

  
  

 

 


— Coughing
— Gagging
— Difficulty swallowing

ë   
     

— Subcutaneous emphysema (Air in the subcutaneous
tissue)
— Dehydration
— Tachycardia
— Tachypnea,
— Dyspnoea,
— Ptyalism (drooling)
— Pyrexia
@ 
  
  


— ]ash in water first to remove mucous and other debris.
— Soak in disinfectant
— ]ash thoroughly to avoid giving the next patient a chemical burn
from the disinfectant

D 
    
 


— Proper lighting
— Secure the tube to prevent it kinking or moving from desired
position
— Proper cuff inflation
— On removal: deflate the cuff at the right time while the patient is
recovering from the anaesthesia, the patient should be able to
swallow to prevent aspiration of any debris in the oral cavity.
r

    
 






— ÷
 
      
 
—         

  
        
         
—        

       
  
—      

 
    

Ñ




— ]hitford,Ñ.E.& Johnsen,K.Preventing Iatrogenic Tracheal
Trauma.Veterinary Technician July 2007(Vol28,No.7)
— www.avma.com
— www.acvc.org
— www.stbethlehemsmallanimalclinic.com
÷