Endotracheal Intubation

Endotracheal IntubationDr. Carla O. Pandrya, SpAnFakultas Kedokteran Universitas Pelita harapan

Tracheal intubationINDICATIONS:Airway protectionNeeds for mechanical ventilationOperation procedure

FOR AIRWAY PROTECTION:Loss of gag reflex eg severe head injuryAirway obstruction eg acute laryngeal edema (inhalational burn, epiglotitis, etc)Anticipated loss control of the airway eg anticipated laryngeal edema (neck trauma)

INDICATIONS FOR MECHANICAL VENTILATION:Ventilation failureLoss of ventilatory drive: stroke, brain injurySpinal cord injuryMyastenia gravisFlail chest, obesityAcute lung injury

Oxygenation failureVentilation perfusion mismatch (pulmonary embolism, emphysema)Inability to extract at cellular level (severe sepsis, cyanide or CO poisoning)

anatomy

How to intubateLaryngoscope held with left handOpen patients mouth insert blade to right side of oropharynxThe tongue swept to the left and up into the floor of pharynx by the blade The tip of curved blade is usually inserted to vallecula, while straight blade to cover epiglottisThe handle of the blade then raised up and away from the patient in a plane that perpendicular to patients mandibule

MALLAMPATI CLASSIFICATIONis used to predict the ease of intubation

ReferencesClinical anesthesiology : Edward Morgan Jr. (Lange)Clinical anesthesiology : Barrash

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