Dr. N.K.

Agrawal
Prof, Dept. Of Anaesthesiology,
JNMC, Sawangi.

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 what is endotracheal intubation?
 what are the indications of intubation?
 equipment required for intubation
 technique of intubation
 confirmation of intubation
 ventilation
 complications
 extubation

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 Endotracheal intubation is the placement of
a special tube in trachea

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 To secure airway
 to supply oxygen
 general Anesthesia
 Cardio pulmonary resucitation
 ventilatory therapy in ICU

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 size of tube
1) 0-1 yrs. 2.5 to 3.5 mm ( plain )
2) 1-3 yrs. 4. to 5 mm
3) 4-6 yrs. 5 to 6 mm
4) 6-10 yrs. 6 to 7 mm ( cuffed )
5) adult female. 7 to 8 mm
6) adult male. 8 to 9 mm
 laryngoscope
 magill's forceps
 Stethoscope
 syringe
 source for ventilation
 suction

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Different sizes of cuffed and plain ETT

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Laryngoscope

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Magill’s forceps ( different sizes)

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Syringe to inflate cuff

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suction

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Raise the head by 5cm with a block or ring pillow

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 Extension at atlanto-occipital joint
 Flexion at neck

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 hold the laryngoscpoe with LEFT hand
irrespective of dominant hand
 open the mouth with right hand index finger with
support of thumb
 introduce Laryngoscpoe from right angle of
mouth
 shift the tongue to left
 go in
 press over tongue
 see epigllotis
 lift ît
 watch for voccal cords

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 take the tube in right hand
 introduce under vision
 confirm placement by auscultation
 if tube is cuffed inflate the cuff with syringe

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 connect the source to tube

 confirmation
a) by auscultation
b) by chest expansion
c) by bag movement
d) end tidal CO2

 fix the tube with adhesive

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conection to ventilate with
 ambu's bag
 anesthesia machine
 ventilator

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- Tachycardia
- rise in blood pressure
- Increase in secretions
- Laryngospasm
- bronchospasm

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 tube in oesophagous
 endobrocheal intubation
 trauma to lips tooth
 Bleeding
 Leak
 Trachities
 Cough
 sore throat
 barotrauma to Lungs

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 increase in supply of O2
 to give general anesthesia
 improove exhalation of C02

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It is advisable if the cause is treated
 throat suction
 Laryngoscopy
 Reflexes
 Spo2
 adequate respiration
 level of consciousness
 extubate

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 if mouth opening restricted
 anterior vocal cords
 burn contracture

one may require other options like

 fibro optic intubatioñ
 awake intubation
 retrogate intubation
 supra epiglotic device

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Laryngeal mask airway (LMA)

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Read See Do Learn
it it it it

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