Pediatric Tracheal Tubes Research Proposal Example | Topics and Well Written Essays - 2250 words

Pediatric Tracheal Tubes - Research Proposal Example 734; Cox 669; Ho 169; Fine & Borland 38). Problems arose in endotracheal intubation particularly for patients that require long-term ventilatory support. Subglottic stenosis was a rare occurrence before the 1960s when tracheostomy was the generally accepted procedure for long-term ventilatory support. However, when prolonged endotracheal tubes were widely used especially for critical care as well as for neonatal intensive care patients, subglottic stenosis cases increased associated with chronic morbidity and fatality (Weiss et al. 734; Cox 669). Traditionally, uncuffed endotracheal tubes were accepted as the tube of choice for intubtation in children below the age of 8 years in all types or duration recommended. This practice, although widely promoted, is being questioned with the advent of new researches on the equal or better performance of cuffed endotracheal tubes in the specified age group. More studies are warranted to once and for all clear this outdated knowledge to further the science in pediatric anesthesia (Ho et al 169; Fine & Borland 38; Weiss et al. 80). Another important area for study, apart from the design and material of cuffed pediatric endotracheal tubes, are the proper tube size and position and depth markings for the said age group. Not only can the success of usage of cuffed tubes be assessed by answering issues around these properties but also the appropriateness of having health care practitioners other than the physician perform endotracheal intubation (Cox 669; Ho 169; Fine & Borland 38). The objectives of this study are (1) to evaluate the difference between a cuffed and an uncuffed endotracheal tube; (2) to determine the success rate of placement; (3) to evaluate the adverse effects of ETT application to patients below eight years old in the non-emergent, elective surgical, operating room setting; and (4) to assess proper tube size selection and placement by an experienced practitioner (nurse anesthetist with greater than one year experience) and relatively inexperienced practitioner (student nurse anesthetist). The above-mentioned objectives will be used to test the following hypotheses: (1) A cuffed endotracheal tube can have equal or better success rates through proper placement by either nurse practitioner; (2) The supposed adverse effects of cuffed ETT such as subglottic edema can be minimized by proper tube size and placement; (3) The experienced practitioner is capable of proper placement of both types of ETT; and (4) the inexperienced practitioner can have higher success rates and reduced laryngoscopy repetition with the cuffed endotracheal tube. Background Applications of endotracheal tubes include the protection of the airway, maintenance of airway integrity, ventilation through positive pressure, induction of positive and expiration pressure, pulmonary outlet and promotion of sufficient oxygenation. Most surgical procedures require short-term or temporary endotracheal tube usage while critical care interventions generally utilize long-term endotracheal tubes (Weiss et al. 734; Cox 669). Endotracheal intubation for anesthesia in adults was developed as early as the 1920s but appropriate apparatus and technique for children were not yet designed during those years. Even until the 1940s, endotracheal intu