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    Et Intubate

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    ctuagent
    This document outlines the indications, techniques, equipment, and complications of endotracheal intubation. Intubation is indicated to support ventilation for patients with respiratory failure, airway obstruction, or loss of consciousness, or to support ventilation during general anesthesia, especially for surgeries near the airway or those requiring prone or lateral positioning. Equipment used includes a laryngoscope, endotracheal tubes sized appropriately for age and gender, a stylet, airways, suction catheters, and monitoring devices. Complications can occur during intubation, from the tube remaining in place, during extubation, or after extubation and include trauma, aspiration, laryngospasm, and edema.

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    Et Intubate

    Uploaded by

    ctuagent
    84 views47 pages
    This document outlines the indications, techniques, equipment, and complications of endotracheal intubation. Intubation is indicated to support ventilation for patients with respiratory failure, airway obstruction, or loss of consciousness, or to support ventilation during general anesthesia, especially for surgeries near the airway or those requiring prone or lateral positioning. Equipment used includes a laryngoscope, endotracheal tubes sized appropriately for age and gender, a stylet, airways, suction catheters, and monitoring devices. Complications can occur during intubation, from the tube remaining in place, during extubation, or after extubation and include trauma, aspiration, laryngospasm, and edema.

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    Intubate

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    This document outlines the indications, techniques, equipment, and complications of endotracheal intubation. Intubation is indicated to support ventilation for patients with respiratory failure, airway obstruction, or loss of consciousness, or to support ventilation during general anesthesia, especially for surgeries near the airway or those requiring prone or lateral positioning. Equipment used includes a laryngoscope, endotracheal tubes sized appropriately for age and gender, a stylet, airways, suction catheters, and monitoring devices. Complications can occur during intubation, from the tube remaining in place, during extubation, or after extubation and include trauma, aspiration, laryngospasm, and edema.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    84 views47 pages

    Et Intubate

    Uploaded by

    ctuagent
    This document outlines the indications, techniques, equipment, and complications of endotracheal intubation. Intubation is indicated to support ventilation for patients with respiratory failure, airway obstruction, or loss of consciousness, or to support ventilation during general anesthesia, especially for surgeries near the airway or those requiring prone or lateral positioning. Equipment used includes a laryngoscope, endotracheal tubes sized appropriately for age and gender, a stylet, airways, suction catheters, and monitoring devices. Complications can occur during intubation, from the tube remaining in place, during extubation, or after extubation and include trauma, aspiration, laryngospasm, and edema.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 47

    INDICATION FOR ENDOTRACHEAL INTUBATION

    1) For supporting ventilation in patient with


    some pathologic disease


    : Upper airway obstruction
    : Respiratory failure
    : Loss of conciousness

    INDICATION FOR ENDOTRACHEAL INTUBATION
    (CONT)
    2) For supporting ventilation
    during general anesthesia



    Type of surgery
    : Operative site near the airway
    : Abdominal or thoracic surgery
    INDICATION FOR ENDOTRACHEAL INTUBATION
    (CONT)


    : Prone or lateral position
    : Long period of surgery
    Patient has risk of pulmonary aspiration
    Difficult mask ventilation
    ANATOMY OF AIRWAY

    : Congenital anomalies ---> Pierre
    Robin syndrome , Downs syndrome
    : Infection in airway-->
    Retropharyngeal abscess,
    Epiglottitis
    : Tumor in oral cavity or larynx
    1) Condition that associated with difficult intubation

    : Enlarge thyroid
    gland

    trachea shift to
    lateral or
    compressed
    tracheal lumen

    1) Condition that associated with difficult intubation (cont)

    : Maxillofacial ,cervical or laryngeal trauma
    : Temperomandibular joint dysfunction
    : Burn scar at face and neck





    : Morbidly obese or pregnancy
    1) Condition that associated with difficult intubation (cont)

    2) Interincisor gap : normal -> more than 3
    cms

    3) Mallampati classification:
    Class 3,4 -> may be difficult
    intubation

    Soft palate
    Uvula
    AIRWAY ASSESSMENT
    grade 3,4 -> risk for
    difficult intubation
    Laryngoscopic view

    4) Thyromental distance : more than 6
    cms

    5) Flexion and extension of
    neck

    6) Movement of temperomandibular joint
    (TMJ)
    Grinding

    1) Laryngoscope : handle and
    blade
    LARYNGOSCOPIC BLADE
    Macintosh (curved) and Miller (straight)
    blade
    Adult : Macintosh blade, small children :
    Miller blade
    Miller blade
    Macintosh blade
    2) Endotracheal tube

    Male: ID 8.0 mms . Female : ID
    7.5 mms
    New born - 3 months : ID 3.0
    mms
    3-9 months : ID 3.5
    mms
    9-18 months : ID 4.0
    mms
    2- 6 yrs : ID =
    (Age/3) + 3.5
    > 6 yrs : ID =
    (Age/4) + 4.5
    1) Size of endotracheal tube : internal diameter (ID)
    3) Endotracheal tube cuff
    High volume
    Low pressure cuff
    Low volume
    High pressure cuff
    2) Material : Red rubber or PVC
    4) Bevel
    5) Murphys eye
    6) Depth of endotracheal tube :
    Midtrachea or below vocal cord ~ 2
    cms
    Adult -> Male = 23 cms ,Female =
    21 cms
    Children
    Oral endotracheal tube = (Age/2) +
    12 (cm)
    Nasal endotracheal tube = (Age/2)
    + 15 (cm)
    7) Tube markings




    Z-79
    Disposible (Do not reuse)
    Oral/ Nasal
    Radiopaque marker
    3
    3.1
    Stylet
    3.2 Oropharyngeal or nasopharyngeal
    airway
    Oral airway Nasal airway
    3.3) Suction catheter
    3.4) Slip joint
    3.5) Face mask and self inflating
    bag




    3.6) Magill forcep
    3.7) Syringe
    3.8) Lubricating jelly
    3.9) Plaster for strap
    endotracheal tube
    4. Monitoring success of
    endotracheal intubation
    4.1) Stethoscope
    4.2) Endtidal - CO
    2

    4.3) Pulse oximeter

    FLEXI ON AT LOWER
    CERVI CAL SPI NE
    EXTENSI ON AT ATLANTO-
    OCCI PI TAL JOI NT


    STEPS OF OROENDOTRACHEAL
    INTUBATION
    STEPS OF OROENDOTRACHEAL
    INTUBATION
    Vareculla
    STEPS OF OROENDOTRACHEAL
    INTUBATION
    STEPS OF OROENDOTRACHEAL
    INTUBATION

    NASOENDOTRACHEAL INTUBATION
    Advantage
    1) Comfortable for prolong
    intubation in postoperative period
    2) Suitable for oral surgery :
    tonsillectomy , mandible surgery
    3) For blind nasal intubation
    4) Can take oral feeding
    5) Resist for kinking and difficult
    to accidental extubation

    1) Trauma to nasal mucosa
    2) Risk for sinusitis in
    prolong intubation
    3) Risk for bacteremia
    4) Smaller diameter than
    oral route -> difficult for
    suction


    1) Fracture base of skull
    2) Coagulopathy
    3) Nasal cavity obstruction
    4) Retropharyngeal
    abscess
    COMPLICATION OF
    ENDOTRACHEAL INTUBATION
    1) During intubation
    : Trauma to lip, tongue or teeth
    : Hypertension and tachycardia
    or arrhythmia
    : Pulmonary aspiration
    : Laryngospasm
    : Bronchospasm

    COMPLICATION OF ENDOTRACHEAL INTUBATION
    (CONT)
    1) During intubation
    : Laryngeal edema

    : Arytenoid dislocation ->
    hoarseness
    : Increased intracranial pressure
    : Spinal cord trauma in cervical
    spine injury
    : Esophageal intubation
    COMPLICATION OF ENDOTRACHEAL
    INTUBATION(CONT)
    : Obstruction from klinking , secretion or
    overinflation of cuff
    : Accidental extubation or endobronchial
    intubation
    : Disconnection from breathing circuit

    2) During remained intubation
    COMPLICATION OF ENDOTRACHEAL
    INTUBATION(CONT)
    2) During remained
    intubation
    : Pulmonary aspiration
    : Lib or nasal ulcer in case with
    prolong period of intubation
    : Sinusitis or otitis in case with
    prolong nasoendotracheal
    intubation
    COMPLICATION OF ENDOTRACHEAL
    INTUBATION(CONT)
    3) During extubation
    Laryngospasm
    Pulmonary aspiration
    Edema of upper airway
    COMPLICATION OF ENDOTRACHEAL
    INTUBATION(CONT)
    4) After
    extubation
    Sore throat
    Hoarseness
    Tracheal
    stenosis
    (Prolong
    intubation)
    Laryngeal
    granuloma

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