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Intubation: Reflection
Intubation: Reflection
Intubation: Reflection
REFLECTION
Nursing Responsibilities:
Before
Aseptic (sterile) procedure
Position patient for comfort depending on site to be inserted
Use local anesthetic; patient may feel pressure as tube is inserted
During
Ensure the ET for placement. Note lip line marking and compare it
with the desired placement (18cm, 20cm, and 22cm).
Closely monitor cuff pressure, maintaining a pressure of 20 to 25
mmHg to minimize the risk of tracheal necrosis.
Use a bite block to avoid patient from biting down.
After
Ensure that the required oxygen support indicated for the patient
is provided.
Assess the client’s respiratory status at least every 2 hours or
frequently as indicated. Note the lung sounds and presence of
secretions.
Ensure that adequate humidity is provided to avoid feeling of
dryness in the oropharynx.
Suction secretions orally to prevent aspiration. This also decreases
the risk for infection.
Assess nasal and oral mucosa for redness and irritation.
Secure the endotracheal tube with tape or ET holder to prevent
movement or deviation of the tube in the trachea.
Place the patient in a side-lying position or semi fowler’s if not
contraindicated to avoid aspiration. Reposition patient every 2
hours. This will allow the lungs to expand better and prevent
secretions stagnation.
Communicate frequently with the client. Give patient means to
communicate using a whiteboard or communication board.