Intubation.pptx

ntubation is a process where a healthcare provider inserts a tube through a person's mouth or nose, then down into their trachea (airway/windpipe). The tube keeps the trachea open so that air can get through. The tube can connect to a machine that delivers air or oxygen.

RAPID SEQUENCE INTUBATION:
Rapid sequence induction (RSI) is a set of actions during induction of anaesthesia in unfasted patients or patients at risk of aspiration/regurgitation of gastric contents.

INDUCTIION AGENT:
Induction agents (sedatives) are integral to the performance of rapid sequence intubation (RSI). They provide amnesia, blunt sympathetic responses, and can improve intubating conditions.

CRICHOID PRESSURE:
Cricoid pressure is applied by an assistant using the thumb and second finger; the first finger stabilizes the thumb and finger on the cricoid ring. press directly backwards at a force of 20-30 newtons against the cervical vertebrae.

endotracheal tube selection
Endotracheal tube selection for male is 8.0 and for female is 7.5

Formula for endotracheal tube children in paediatrics is
 [(Age/4) + 4] for uncuffed tubes
[(Age/4) +3.5] for cuffed tubes

1. INTUBATION SUBMITTED BY PANKAJ SINGH RANA NURSE PRACTITIONER

2. introduction Intubation is a procedure by which a tube is inserted in the lungs to provide ventilation to the lungs. Intubation is life saving procedure. It help maintain airway access.

3. Most common words used during intubation RAPID SEQUENCE INTUBATION: Rapid sequence induction (RSI) is a set of actions during induction of anaesthesia in unfasted patients or patients at risk of aspiration/regurgitation of gastric contents. INDUCTIION AGENT: Induction agents (sedatives) are integral to the performance of rapid sequence intubation (RSI ). They provide amnesia, blunt sympathetic responses, and can improve intubating conditions. CRICHOID PRESSURE: Cricoid pressure is applied by an assistant using the thumb and second finger; the first finger stabilizes the thumb and finger on the cricoid ring . press directly backwards at a force of 20-30 newtons against the cervical vertebrae.

4. indication Airway obstruction (something caught in the airway, blocking the flow of air). Cardiac arrest (sudden loss of heart function). Injury or trauma to your neck, abdomen or chest that affects the airway. Loss of consciousness or a low level of consciousness, GCS below 7 Preoperative Respiratory failure or apnea (a temporary stop in breathing). Risk for aspiration (breathing in an object or substance such as food, vomit or blood ). Shock

5. Equipment Intravenous access Hemodynamic monitoring  Stethoscope Pulse oximeter End-tidal carbon dioxide (EtCO2) monitor Suction catheter attached to continuous suction Laryngoscope Endotracheal tube Cardiac arrest cart with resuscitation medications  Rapid sequence intubation medications (paralytic, sedative, and/or dissociative agent)  Defibrillator 

6. Airway evaluation Check for difficult airway. restricted cervical motion obesity facial or neck trauma burn

7. Endotracheal tube selection Endotracheal tube selection for male is 8.0 and for female is 7.5 Formula for endotracheal tube children in paediatrics is  [(Age/4) + 4] for uncuffed tubes [(Age/4) +3.5] for cuffed tubes

8. sedative Midazolam Ketamine Fentanyl Propofol Etomidate Succinylcholine (ultra-short acting) Rocuronium Vecurounium Atracurium Muscle relaxant drugs

9. INTUBATION PROCEDURE

10. Procedure of intubation Insert an IV needle into your arm . Deliver medications through the IV to put you to sleep and prevent pain during the procedure (anaesthesia).

11. Place an oxygen mask over your nose and mouth to give your body a little extra oxygen . Provide bag mask ventilation if unable to achieve target saturation .

12. Prepare the patient by giving patient appropriate position for intubation (sniffing position, a combination of flexion of the neck and extension of the head )

13. Tilt your head back and insert a laryngoscope into your mouth. Move the tool toward the back of your mouth, avoiding your teeth . Raise the epiglottis, a flap of tissue that hangs in the back of the mouth to protect your larynx (voice box).

14. Inflate ET tube

15. Place tape on the side of your mouth or a strap around your head to keep the tracheal tube in place.

16. Confirmation of to be done by

17. Intubation failure Use of following in case of intubation failure Laryngeal mask airway (LMA) Bougie Cricothyrotomy tray  Magill forceps

18. BOUGIE

19. Magill forceps  are angled forceps used to guide a tracheal tube into the larynx or a nasogastric tube into the esophagus under direct vision.

20. complication damage to the vocal cords B leeding I nfection T earing or puncturing of tissue in the chest cavity that can lead to lung collapse (tension pneumothorax) I njury to throat or trachea Injury to teeth Aspiration