Endotracheal intubation
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Endotracheal intubation involves placing a flexible plastic tube into the trachea to maintain an open airway or administer drugs. It is used to administer oxygen, remove secretions, ventilate the lungs, and treat respiratory failure. Indications include CNS depression, neuromuscular disease, chest injuries, airway obstruction, and aspiration risk. The procedure requires a laryngoscope, ET tube, suction equipment, and securing the tube once placed to ventilate the lungs. Complications can include injury and intubation in the wrong airway.
Endotracheal intubation
- 1. ENDOTRACHEALENDOTRACHEAL INTUBATIONINTUBATION PRESENTED BY 1Year MSc Nursing Lourdes college of Nursing Ernakulum
- 2. DEFINITIONDEFINITION Endotracheal intubation is the placement of a flexible plastic tube into the trachea to maintain an open airway or to serve as a conduit through which to administer certain drugs.
- 3. PURPOSEPURPOSE To administer oxygen To remove secretions To ventilate the lungs. To establish and maintain airway To treat acute respiratory failure and persistent hypoxemia.
- 4. INDICATIONSINDICATIONS CNS Depression. Neuromuscular disease. Chest wall injury. Upper airway obstruction. Aspiration prophylaxis. Fracture vertebrae and spinal cord .
- 5. ARTICLES REQUIREDARTICLES REQUIRED Sand Bag /Towel roll Suction apparatus with Tubing Suction Catheter Ambu bag and Mask Oxygen source and Tubing Laryngoscope with appropriate size blade Magill’s Forceps
- 6. Cont..Cont.. Endo tracheal tube of appropriate size Stylette Xylocaine jelly Plastic syringe 10ml Oral airway Cotton Tape Gloves Face mask
- 7. Different sizes of cuffed and plainDifferent sizes of cuffed and plain ET TubesET Tubes
- 10. SYRINGE TO INFLATE CUFFSYRINGE TO INFLATE CUFF
- 12. Technique of IntubationTechnique of Intubation Raise the head by 5 cm with a block or towel roll
- 13. POSITION FORPOSITION FOR INTUBATIONINTUBATION Position your patient in supine position with head extended by keeping sand bag or towel role under the neck.
- 15. PROCEDUREPROCEDURE Hold the laryngoscope with LEFT hand irrespective of dominant hand Open the mouth with right hand index finger with support of thumb. Introduce Laryngoscope from right angle of mouth Shift the tongue to left and go in. Press over tongue. See epiglottis and lift it. Watch for vocal cord
- 18. Cont…Cont… Take the tube in right hand Introduce under vision Confirm placement by auscultation If tube is cuffed inflate the cuff
- 19. Cont..Cont.. Connect the source to tube Confirm the position of tube a) by auscultation b) by chest expansion c) by bag movement Fix the tube with adhesive.
- 20. Stabilizing ET TubeStabilizing ET Tube
- 21. Cont..Cont.. Connection to ventilate with -ambu's bag -anesthesia machine -ventilator
- 22. ENDO TRACHEAL TUBE INENDO TRACHEAL TUBE IN PLACEPLACE
- 23. POST PROCEDURE CAREPOST PROCEDURE CARE Place the patient in lateral position Arrange for chest X-ray in order to check placement of ET Tube Apply endotracheal suctioning as needed. Watch for chest movements,ET Tube kinking, obstruction,leakage of tube cuff and over inflation of cuff
- 24. COMPLICATIONSCOMPLICATIONS Tube in esophagus Endo bronchial Intubation Trauma to lips and tooth Laryngeal and tracheal Injury Baro trauma to lungs Bleeding Tracheities Pulmonary infection and sepsis
Editor's Notes
- #5: Miller Blade is straight – directly lifts the epiglottis to allow visualization of the vocal cords. MacIntosh – blade is curved; inserted into the vallecula to indirectly lift the epiglottis. Infants are always intubated with the Miller die to the floppy airway.