Endotracheal Intubation procedure
Equipment required for ET tube insertion;
1. Laryngoscope
(check size; blade should reach between the lips and larynx; turn on light).
2. Cuffed endotracheal tube
3. Syringe for cuff inflation
4. Tape
5. Suction catheter
6. Ventilation bag
7. Face mask
8. Oxygen supply
9. Medications in awake patient, if required to aid intubation
10. Cardiac monitor, pulse oximeter, blood pressure
11.Airway
Endotracheal intubation insertion
1. Give medication, if required.
2. Pre-oxygenate patient with high concentration oxygen for 3 to 5 minutes.
3. Position the patient
Patient position be in sniffing position (combination of flexion of the neck and extension of the head).
4. Stand behind the head of the patient.
5. Open mouth and inspect; remove any dentures/debris and suction any secretions if present before ET intubation.
6. Holding laryngoscope in left hand, insert it looking down its length, epiglottis are seen then V-shaped glottis can be seen.
(Laryngoscopes are designed for visualization of the vocal cords and for placement of the ETT into the trachea under direct vision).
7. Insert the ET tube in the groove of the laryngoscope so that the cuff passes the vocal cords.
8. Remove laryngoscope and inflate the cuff of the tube with 15ml air from a 20ml syringe.
ET tube attach ventilation bag/machine and ventilate the patient (10 breaths/min) with high concentration oxygen and observe chest expansion and auscultate to confirm correct positioning.
9. After successfully intubating the patient the depth of the endotracheal tube ending at the teeth or lips should be noted.
Recommend depth of placement of ET to be 21 cm in adult female and 23 cm in adult males.
9. Secure the endotracheal tube with tape (one side of mouth)
10. Chest X ray done for check correct placement of ET tube.
11. Documenting the patient's file.
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