Endotracheal Intubation Flashcards
A flexible tube placed inside the trachea of an anesthetized used to transfer gases directly from the anesthetic machine into the lungs
ET tube
ET tubes help prevent
atelectasis
These tubes have a beveled edge and a Murphy eye and may or may not have a cuff
Murphy tubes
These tubes have no cuff or side hole, but decrease in diameter at the patient’s end
Used in birds and reptiles
Cole tubes
Cuffed or uncuffed with no hole at the tip
Magill
Creates a seal between the tube and the trachea
Cuff
Tube lumen is measured in
MM (ID)
Tube length is measured in
cms
A device used to increase visibility of the larynx when placing an ET tube
Laryngoscope
Patient end has a
cuff
Machine end
attaches to the breathing circuit
This indicates the cuff has been inflated and some require manual deflation
Pilot balloon
Straight blades of laryngoscopes
Miller
Curved blades of laryngoscopes
Macintosh
Performed after induction or used for pts with respiratory or cardiac arrest for manual ventilation
Endotracheal intubations
Predisposed to laryngospasms
Cats
Can be used to facilitate intubation when smaller tubes are used to help prevent the bending of the tube
Should never extend past the patient end of tube
Stylette
Breed and anatomy play a role in selecting the correct tube because of the
length
Cats ET tubes should range
3-4.5 mm
Dogs that are 20 kg tubes should range
9.5-10mm
If a dog weighs more than 20 kg, the tube length should
increase 1 mm for every 5 kgs
If a tube is too long, it creates more
dead space
The patient end of the tube should lie
between the thoracic inlet and the larynx
The tube should extend from the tip of the nose to
the thoracic inlet
You can use this to help ease the passing of the tube
lubrication
6 Supplies to have ready for intubation
- Scope
- 3 tubes of varying size
- tie in
- 3x3 gauze
- air syringe
- lidocaine (for cats)
Restrainer should hold behind these teeth and extend the head and neck forward
canines
2 positions an animal can be in for intubation
- sternal
2. lateral
Horses should be positioned during intubation
lateral, with extended heat, neck and back
Must be assessed by the restrainer prior to intubation
jaw tone
Window for successful intubation is
short
You should tie the tube around the
maxilla, mandible, or behind the ears
Animals will not do this with proper placement
vocalize
ET tube is advanced too far, breath sounds will be absent on one side and cause possible cyanosis
One lung intubation
If this occurs, you can see extreme respiratory distress
Bronchial intubation
This knot technique works really well for tying the tube
lark’s head
Prevents aspiration, waste gas, and problems maintaining depth at normal concentrations
Cuffing
How much air should you inject into the cuff?
5ml
While slowly inflating the cuff, you should compress this and listen for leakage around the cuff
reserve bag
If you hear this noise, there is a leak around the cuff
hissing
This can cause tracheal trauma or necrosis
Overinflation of the cuff
This can cause inadequate depth, contamination of room with inhalant
Underinflation
This can help treat laryngospasms in cats
lidocaine
Most common complication of endotracheal intubation
placing the tube into the esophagus
This reflex must return before trying to extubate
swallowing
Brachycephalic breeds should be extubated when
they are fully conscious
This tube type is made of PVC polyvinyl chloride
Transparent, stiffer, cuff needs manually deflated, and high volume/low pressure
Easy on the trachea
Vinyl
This type of tube is orange-red and not transparent
More flexible and inexpensive but prone to kinking and collapsing
Tends to dry and crack because it absorbs disinfectants
Cuff automatically deflates with cap release
Low volume, high pressure
Red rubber
More expensive tube but combines strength and pliability
Less irritating to tissues and cuff requires manual deflation
High volume/low pressure
Considered the best
Silicone
Specialized rubber tubes that contain a coil of metal or nylon embedded into the rubber designed to resist kinking or collapse
Used in human medicine
Spiral or anode
Performed in emergency situations to establish an airway when endotracheal intubation is contraindicated or impossible
Tracheostomy
A method of oxygen delivery
Ambu bag
