Endotracheal intubation Flashcards
1
Q
What is endotracheal intubation
A
Placement of a tube into trachea inserted via nose or orally
2
Q
Indications for Endotracheal intubation
A
- To prevent aspiration of gastric contents, bloods/secretions
- When complete neuromuscular blockade is required
- When intermittent positive pressure ventilation is required
- If airway is difficult to manage by other means
- For ventillation in ITU
- For resuscitation, secures airway
- Optimises ventilation/oxygenation
- Allows suctioning of lower airway
3
Q
Complications of endotracheal intubation
A
- Vomiting, regurgitation or aspitration
- Failed intubation leading to hypoxia leading to dealth
- Hypertension and tachychardia as a result of laryngoscopy
- Dsyrhythmias due to vagal stimulation
- Hypotension due to drugs eg propoful
- Tauama/bleeding to upper airway
- Complications of ET tube blockage or disconnection
- Laryngospasm
- Laryngeal odema
4
Q
Distinguish between vomiting, reflus, regurgitation and aspiration
A
- Vomiting - active process
- Regurgitation - passive process. Gastric contents in pharynx
- Reflux - gastric contents in osephagus
- Aspiration - gastric contents in lungs
5
Q
List key Features of ET tube
A
- Internal diameter corresponds with tube size ( eg. 7.5mm - 8mmfor woman and 8mm to 8.5mm for man)
- length markers (24cm female, 25 cm male
- made from pvc
- cuff
- murphys eye
- radio opaaue
- intubation depth marker
6
Q
Intubation process (11 steps)
A
- Prepare and check equipment/drugs
- Monitoring
- Position Patient
- Pre-oxygenate
- Induction agent
- Confirm that ventilation is possible
- Muscle relaxant
- Laryngoscopy
- Pass ET tine and inflate cuff
- Confirm position
- Secure tube
7
Q
Verification of ET tube placement
A
- End tidal CO2
- Seeing tube pass through cords
- Bilateral symmetrical chest movements
- Bilateral breath sounds
- Feel and refill of reserviour bag
- Misting of ET tube
- Oxygen sats
8
Q
Laryngoscopy process
A
Laryngoscope in Left hand
Insert from right to left
Visualise anatomy
Blade in vallecula
Lift up and away
Do not lever on teeth
Lift empiglottis indirectly (curved blade)
