Endotracheal Intubation Flashcards
What animal is prone to laryngeal spasm?
Cats
What can we do to prevent laryngeal spasm in cats?
Spray with lidocaine (xylazine) or apply 1-2 drops on the vocal folds
How long does it take for lidocaine to work for laryngeal spasm?
30-60 seconds
What indicates that the ET tube is in the trachea and not the esophagus?
Reservoir bag should move in sync with the breath
What should happen to the unidirectional valves if the ET tube is correctly placed?
They should move with each breath
What can be felt at the connector end of the tube if it is in the trachea?
Forced air with each expiration
How can bilateral chest compressions help confirm ET tube placement?
Air should come out of the connector end of the tube when pushing on the chest
What should occur with the lumen of the tube during expiration if correctly placed?
Fogging of the lumen
How should the ventral neck feel if the ET tube is in the trachea?
Only one firm tube should be felt
What does vocalization from the patient indicate regarding ET tube placement?
The tube is incorrectly placed
What does coughing generally indicate about ET tube placement?
The tube is in the trachea but could also mean it is in the esophagus
What is a capnograph used for in confirming ET tube placement?
To show appropriate waveform and end-tidal CO2
What can be used at the connector end of the ET tube to confirm proper placement?
Few strands of gauze or hair that will blow away with each expiration
What is the most reliable way to confirm ET tube placement?
Visualizing the tube between the vocal folds
What is the best and surest way to confirm tube placement?
Visualizing
Visualizing the tube placement can include direct observation of tube positioning in the airway.
What are 3 other ways to confirm tube placement?
- Air movement
- Fogging in tube
- Palpation
- Vocalization
- Cough
- Capnograph
- Blowing gauze/hair
These methods can help verify that the tube is correctly positioned in the trachea.
What are 3 potential complications of intubation?
- Stimulation of vagus nerve
- Brachycephalic breeds airway collapse
- Overzealous intubation
- Overinflated cuff
- Obstruction of tube
Each complication can lead to significant respiratory issues or injury during intubation.
How can you test your cuff for leaks before it is in your patient?
- Place in water and watch for bubbles
- Blow cuff up, wait 1-2 minutes to see if deflates
Testing for leaks is crucial to ensure proper inflation and function during intubation.
How do you test to see if the cuff needs to be inflated once it is in your patient?
Close pop off valve & squeeze reservoir bag (< 20cm H20) & listen for leaks
This method helps assess the integrity of the cuff while in use.
Do all ET tubes need to have the cuff inflated?
Not all ET tubes need to have their cuff inflated
The need for cuff inflation depends on the specific situation and type of ET tube used.
How can you tell if the cuff of an ET tube needs to be inflated?
Check by closing the pop off valve and squeezing the reservoir bag while ensuring the manometer does not go above 20 cm H2O and listening for leakage of gas around the ET tube
If there is leakage, slowly inflate the cuff until the leaking air goes away.
What should you do if you smell anesthetic gases when using an ET tube?
Inflate the cuff until the smell goes away
This indicates that the cuff may not be sealing properly and requires inflation.
