ENDOTRACHEAL ENDOTRACHEAL
INTUBATIONINTUBATION
PRESENTED BY
1Year MSc Nursing
Lourdes college of Nursing
Ernakulum
DEFINITIONDEFINITION
Endotracheal intubation
is the placement of a flexible
plastic tube into the trachea
to maintain an open airway
or to serve as a conduit
through which to administer
certain drugs.
PURPOSEPURPOSE
To administer oxygen
To remove secretions
To ventilate the lungs.
To establish and maintain airway
To treat acute respiratory failure and
persistent hypoxemia.
ARTICLES REQUIREDARTICLES REQUIRED
Sand Bag /Towel roll
Suction apparatus with Tubing
Suction Catheter
Ambu bag and Mask
Oxygen source and Tubing
Laryngoscope with appropriate size blade
Magill’s Forceps
Different sizes of cuffed and plain Different sizes of cuffed and plain
ET TubesET Tubes
LARYNGEOSCOPELARYNGEOSCOPE
MAGILL’S FORCEPSMAGILL’S FORCEPS
SYRINGE TO INFLATE CUFFSYRINGE TO INFLATE CUFF
SUCTION APPARATUSSUCTION APPARATUS
Technique of IntubationTechnique of Intubation
Raise the head by 5 cm with a block or
towel roll
POSITION FOR POSITION FOR
INTUBATIONINTUBATION
Position your patient
in supine position
with head extended
by keeping sand bag
or towel role under
the neck.
PROCEDUREPROCEDURE
Hold the laryngoscope with LEFT hand
irrespective of dominant hand
Open the mouth with right hand index finger
with support of thumb.
Introduce Laryngoscope from right angle of
mouth
Shift the tongue to left and go in.
Press over tongue.
See epiglottis and lift it.
Watch for vocal cord
Procedure cont..Procedure cont..
Procedure cont..Procedure cont..
Cont…Cont…
Take the tube in right hand
Introduce under vision
Confirm placement by
auscultation
If tube is cuffed inflate the cuff
Cont..Cont..
Connect the source to tube
Confirm the position of tube
a) by auscultation
b) by chest expansion
c) by bag movement
Fix the tube with adhesive.
Stabilizing ET TubeStabilizing ET Tube
Cont..Cont..
Connection to ventilate
with
-ambu's bag
-anesthesia machine
-ventilator
ENDO TRACHEAL TUBE IN ENDO TRACHEAL TUBE IN
PLACEPLACE
POST PROCEDURE CAREPOST PROCEDURE CARE
Place the patient in lateral position
Arrange for chest X-ray in order to
check placement of ET Tube
Apply endotracheal suctioning as needed.
Watch for chest movements,ET Tube
kinking, obstruction,leakage of tube cuff
and over inflation of cuff
COMPLICATIONSCOMPLICATIONS
Tube in esophagus
Endo bronchial Intubation
Trauma to lips and tooth
Laryngeal and tracheal Injury
Baro trauma to lungs
Bleeding
Tracheities
Pulmonary infection and sepsis