endotracheal intubation

Dr. N.K. AgrawalProf, Dept. Of Anaesthesiology,

JNMC, Sawangi.

1

what is endotracheal intubation?

what are the indications of intubation?

equipment required for intubation

technique of intubation

confirmation of intubation

ventilation

complications

extubation

2

Endotracheal intubation is the placement of a special tube in trachea

3

To secure airway

to supply oxygen

general Anesthesia

Cardio pulmonary resucitation

ventilatory therapy in ICU

4

size of tube 1) 0-1 yrs. 2.5 to 3.5 mm ( plain ) 2) 1-3 yrs. 4. to 5 mm3) 4-6 yrs. 5 to 6 mm4) 6-10 yrs. 6 to 7 mm ( cuffed )5) adult female. 7 to 8 mm6) adult male. 8 to 9 mm

laryngoscope magill's forceps Stethoscope syringe source for ventilation suction

5

Different sizes of cuffed and plain ETT

6

Laryngoscope

7

Magill’s forceps ( different sizes)

8

Syringe to inflate cuff

9

suction

10

Raise the head by 5cm with a block or ring pillow

11

Extension at atlanto-occipital joint

Flexion at neck

12

13

hold the laryngoscpoe with LEFT handirrespective of dominant hand

open the mouth with right hand index finger with support of thumb

introduce Laryngoscpoe from right angle of mouth

shift the tongue to left go in press over tongue see epigllotis lift ît watch for voccal cords

14

15

take the tube in right hand

introduce under vision

confirm placement by auscultation

if tube is cuffed inflate the cuff with syringe

16

connect the source to tube

confirmation a) by auscultationb) by chest expansionc) by bag movement d) end tidal CO2

fix the tube with adhesive

17

conection to ventilate with

ambu's bag

anesthesia machine

ventilator

18

- Tachycardia

- rise in blood pressure

- Increase in secretions

- Laryngospasm

- bronchospasm

19

tube in oesophagous

endobrocheal intubation

trauma to lips tooth

Bleeding

Leak

Trachities

Cough

sore throat

barotrauma to Lungs

20

increase in supply of O2

to give general anesthesia

improove exhalation of C02

21

It is advisable if the cause is treated

throat suction

Laryngoscopy

Reflexes

Spo2

adequate respiration

level of consciousness

extubate

22

if mouth opening restricted

anterior vocal cords

burn contracture

one may require other options like

fibro optic intubatioñ

awake intubation

retrogate intubation

supra epiglotic device

23

Laryngeal mask airway (LMA)

24

Read it

See it

Do it

Learn it

25