Endotracheal Intubation

Question 1

Paramedic level required to intubate?

Answer 1

ACP or CCP

Question 2

What physiological functions are bypassed when performing endotracheal intubation?

Answer 2

Warming, humidifying and filtering air before it enters the lower airway.

Question 3

Purpose of the laryngoscope?

Answer 3

Used to lift the tongue and epiglottis out of the way so you can see the vocal chords.

Question 4

2 components required to assemble a laryngoscope?

Answer 4

Handle and blade.

Question 5

What are the two types of laryngoscope blades?

Answer 5

Curved or Macintosh

Straight or Miller

Question 6

ETT tubes range from ____ cm to ____ cm in length?

Answer 6

12cm to 32cm

Question 7

Approximately how many ml of volume does the distal cuff of an ETT hold?

Answer 7

5-10ml

Question 8

How does the air remain in the cuff once the syringe is removed?

Answer 8

A one way valve at the proximal end of the tube holds the air in place.

Question 9

How do you tell if the cuff in the trachea is properly inflated?

Answer 9

A small pilot balloon on the inflation tubes proximal end is properly inflated.

Question 10

Problem with over inflating the distal cuff of an ETT?

Answer 10

It will pressure the tracheal mucosa. This could cause ischemia of the trachea wall.

Question 11

Typical size tubes (diameter) for average adult patients?

Answer 11

7. 0-9.0mm

7. 0 - 8.0mm female, 7.5 - 8.5mm male

Question 12

What is the function of a stylet?

Answer 12

It is a malleable plastic covered metal wire used to direct the ETT anteriorly into the glottic opening.

Question 13

How could you avoid damaging tissue with the tip of the stylet while inserting?

Answer 13

Keep it recessed within the ETT at least 1cm.

Question 14

Purpose of the 10ml syringe used in conjunction with an ETT tube?

Answer 14

Used to inflate the distal cuff.

Question 15

Besides becoming dislodged, why are tube-holding devices used to secure ETT’s in place?

4 answers.

Answer 15

• Movement can cause cardiovascular stimulation.
• Increase intracranial pressure.
• Injure tracheal mucosa.
• Person providing ventilations could push ETT down into left or right mainstem bronchus.

Question 16

Scissor style clamps with circular tips?

Answer 16

Magill Forceps.

Question 17

What type of lubricant is used to insert ETT?

Answer 17

Water soluble.

Question 18

Indications for endotracheal intubation?

4 answers

Answer 18

• Respiratory or Cardiac arrest.
• Unresponsiveness without gag reflex.
• Inability to protect airway increasing risk of aspiration.
• Obstruction due to foreign bodies, trauma, burns or anaphylaxis.

Question 19

T or F. If epiglottitis is present, one should not attempt intubation unless airway failure is imminent.

Answer 19

True.

Question 20

Manipulating the airway in patients with epiglottitis will likely result in _______________?

Answer 20

Vigorous laryngospasm.

Question 21

T or F. ETT’s impede gastric distension by channeling air directly into the trachea.

Answer 21

True.

Question 22

T or F. ETT’s can be inserted blindly?

Answer 22

False.

Question 23

ETT’s permit administration of the following medications..

N\_\_\_\_\_\_\_\_\_\_
A\_\_\_\_\_\_\_\_\_\_
V\_\_\_\_\_\_\_\_\_\_
E\_\_\_\_\_\_\_\_\_\_
L\_\_\_\_\_\_\_\_\_\_

Answer 23

Naloxone (narcan)
Atropine
Ventolin (salbutamol)
Epinephrine 
Lidocaine