Clinical Procedure
 
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A means of providing oxygenation with high pressure gas flow.
Jet ventilation may be
1. supraglottic (when an unobstructed view of the glottis is required),
2. subglottic, or
3. transtracheal (following an emergency needle cricothyroidotomy).

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manujet jet-ventilator setup with various sizes of cricoithyrotomy needles and adapter.

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When using the Hunsaker monjet, the sampling line is small in calibre and can easily block with mucous. Place a three way tap on sampling line port and intermittently turn 3 way tap and inject 10ml of air via the side-port.

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Ensure chest is exposed so that it can be observed to rise and fall.

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Ensure surgeons maintain airway patency to allow escape of pressure, otherwise the patient is at risk of barotrauma/pneumothorax

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To assess adequacy of ventilation, place hands on chest wall feeling for a rise, and watch oximitery. If either is a problem, ensure patient is adequately relaxed, and increase jet pressure as required.

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A recruitment maneuver (eg 20cm for 20secs) prior to commencing jet ventilation will help maintain a larger FRC whilst jet ventilating.

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Hyperventilating prior to commencing jet ventilation will help prolong normocapnic jet ventilation.
In addition, reducing alveolar CO2 may help increase alveolar O2 as per the alveolar gas equation.

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Total intravenous-anesthesia will be required as delivery of volatile anesthesia will be unreliable

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Good description and images of Benjet tube distal subglottic ventilation refl.in/2r

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