endotracheal intubation
TRANSCRIPT
Dr. N.K. AgrawalProf, Dept. Of Anaesthesiology,
JNMC, Sawangi.
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what is endotracheal intubation?
what are the indications of intubation?
equipment required for intubation
technique of intubation
confirmation of intubation
ventilation
complications
extubation
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Endotracheal intubation is the placement of a special tube in trachea
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To secure airway
to supply oxygen
general Anesthesia
Cardio pulmonary resucitation
ventilatory therapy in ICU
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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
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Different sizes of cuffed and plain ETT
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Laryngoscope
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Magill’s forceps ( different sizes)
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Syringe to inflate cuff
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suction
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Raise the head by 5cm with a block or ring pillow
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Extension at atlanto-occipital joint
Flexion at neck
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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
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take the tube in right hand
introduce under vision
confirm placement by auscultation
if tube is cuffed inflate the cuff with syringe
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connect the source to tube
confirmation a) by auscultationb) by chest expansionc) by bag movement d) end tidal CO2
fix the tube with adhesive
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conection to ventilate with
ambu's bag
anesthesia machine
ventilator
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- Tachycardia
- rise in blood pressure
- Increase in secretions
- Laryngospasm
- bronchospasm
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tube in oesophagous
endobrocheal intubation
trauma to lips tooth
Bleeding
Leak
Trachities
Cough
sore throat
barotrauma to Lungs
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increase in supply of O2
to give general anesthesia
improove exhalation of C02
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It is advisable if the cause is treated
throat suction
Laryngoscopy
Reflexes
Spo2
adequate respiration
level of consciousness
extubate
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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
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Laryngeal mask airway (LMA)
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