Intubation Airways

Calista Alvarez
1st period
http://intensivecarehotline.com/breathing-tube-or-endotracheal-tube/

Sunday, November 29, 15

Introduction

Calista Alvarez

Product Title: Intubation Airways

Mentor: Denise Wilkes, M.D.

Mentors place of business: John Sealy Hospital & UTMB

Pain Clinic

Mrs. Kristi Click

HST ISM - Fall 2015

*some information in this presentation comes from outside sources

Sunday, November 29, 15

My Mentor

Graduated from University

of California Berkley and
studied bio-resource sciences

Came to Texas and went to

UTMB to specialize in
anesthesiology, pain
management, palliative care
and hospice care.

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Mentors Place of Business

John Sealy UTMB

Galveston
http://www.utmbhealth.com/oth/Page.asp?PageID=OTH000004

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UTMB Pain Clinic

Victory Lakes
http://www.utmbhealth.com/oth/Page.asp?PageID=OTH000938

Operating room (OR) in John Sealy Hospital

*picture taken by me, Calista Alvarez

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ISM

ISM is an advanced course designed for students who wish

to mentor an adult professional in their chosen career. The
student will meet with their mentor for two hours a week
and report in a journal entry what experiences that they had
while at their mentors place of business. The student will
have many assignments that will help lead up to their final
presentation. The students must also complete a midterm
presentation to show the class and then work their way up
to the final presentation where they will be graded by their
mentor and two evaluators for a major grade.
*some information in this presentation comes from outside sources

Sunday, November 29, 15

Online portfolio

As one of our
assignments for
ISM, we had to
make an online
portfolio on
Weebly.com. This
portfolio showcases
all of our major
assignments we have
completed
throughout the
semester.

calistalalvarez.weebly.com

*some information in this presentation comes from outside sources

Sunday, November 29, 15

My Topic

My topic is the dierent airways used during intubation.

I focused on the two major intubation airways:

Nasal

Endotracheal

http://www.tenhoo-med.com/p-ANESTHESIA-AIRWAY-42782/Endotracheal-Tubes-42810/

Sunday, November 29, 15

http://eastmed01.en.made-in-china.com/product-group/
GemxlRFETpUV/Disposable-Catheter-and-Tubecatalog-1.html

My Topic Question

Which

airway it the most

common? Why?

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Why I Chose this Topic

I chose this topic in particular because my goal is to

eventually become an anesthesiologist, and so by doing this
project, I will be able to know about the dierent types of
airways that an anesthesiologist will use while intubating a
patient. It will ultimately benefit my future in medicine.

http://www.readmedicine.com/p_medical_degrees_gmc.htm

Sunday, November 29, 15

Definitions

Intubation: when you insert a tube into a person or body part, especially the
trachea for ventilation.

Anesthesia: insensitivity to pain, especially as artificially induced by the

administration of gases or the injection of drugs before surgical operations.

Trachea: a large membraneous tube reinforced by rings of cartilage, extending

from the larynx to the bronchial tubes and conveying air to and from the lungs;
the windpipe.

Larynx: the hollow muscular organ forming an air passage to the lungs and
holding the vocal cords in humans and other mammals; the voice box.

Anesthesia: a way to control pain during a surgery or procedure by using

medicine called anesthetics. It can help control your breathing, blood pressure,
blood flow, and heart rate and rhythm.
http://www.merriam-webster.com

Sunday, November 29, 15

Anesthesia Algorithm

"Anesthesiologists have developed many tools to rescue

patients from life-threatening situations, from the
laryngoscope to the pulse oximeter to crisis management in
the simulator. The latest of these is the Emergency Manual,
a cognitive aid for any medical provider confronted with a
crashing patient. This tool will save lives."

-Richard P. Dutton, MD, MBA

Executive Director, Anesthesia Quality Institute

http://emergencymanual.stanford.edu

Sunday, November 29, 15

http://emergencymanual.stanford.edu
Sunday, November 29, 15

Anesthesia

During my mentorship, my mentor was on call in the operating

room for many of the times I went to see her. In the operating
room she would explain the procedures an anesthesiologist would
do before, during and after the surgery was completed. With this
being said, they would show me the most common drugs used to
render the patient unconscious. The most common used were
Propofol, Fetnyl, Ketalar, and Diprivan.

http://articles.latimes.com/2012/nov/05/science/la-sci-sn-general-anesthesia-may-disrupt-communication-between-brain-areas-20121105

Sunday, November 29, 15

My Product

For my product, I decided to show my audience how

intubation works by using props to explain the intubation
procedure.

For my props I have 2 intubation tubes, and a styrofoam

head representing my patient that I will be operating on.

http://www.vanguardsurvival.com/first-aid/advanced-aid-survival-part-2/

Sunday, November 29, 15

http://www.vanguardsurvival.com/wp-content/uploads/2014/07/da1c15.png

Endotracheal Intubation

This is a certain medical device to help open a patients

airway to allow maximum oxygen flow to the lungs.

This process begins with a metal laryngoscope, so the

anesthesiologist can see the trachea. Then the tube is placed
down in the patients mouth and into the trachea.

Risks: If tube is placed too deep, it could result in

pneumothorax or when only one lung is ventilated. Also, if
tube is placed improperly aspirations of stomach contents
can occur.
http://www.medicinenet.com/endotracheal_intubation/article.htm

Sunday, November 29, 15

Endotracheal Tube
Picture of
endotracheal tube
taken at John
Sealy Hospital.

Sunday, November 29, 15

Nasal Intubation

Nasal Intubation is used when a patient is undergoing oral

surgery or, if there are complications doing endotracheal
intubation.

The nasal route in the spontaneously ventilating patient was

once considered a technique of choice for emergency
operations, but endotracheal intubation under direct vision
following the rapid sequence induction of anesthesia is now
the technique of choice.

Most commonly used in the field of dentistry.

http://emedicine.medscape.com/article/1663655-overview

Sunday, November 29, 15

Nasal Tube
This is a
picture of a
nasal tube
taken at John
Sealy Hospital.

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Video-Endotracheal
Intubation

https://www.youtube.com/watch?v=Sb1ubawTd4w
Sunday, November 29, 15

Most Common Intubation

Airway

ENDOTRACHEAL!

Why?

Sunday, November 29, 15

It is most commonly used due to accessibility in a

hospital and in a hospital many patients will come into
the operating room for orthopedic, cardiac, spinal, neuro
or endoscopy treatments that do not require nasal
intubation.

Research : Preparation of the Patient

and the Airway for Awake Intubation.

Although one airway may be used more commonly, all intubation routes may be dicult to perform.

In emergency situations the 1-2-3 rule is applied so intubation is completed quicker

The anesthesiologist must always make sure the patient trusts them before going into surgery.

Once the patient perceives the anesthesiologist to be empathetic and understanding, the major portion of
the battle is won.

Endotracheal intubation is best performed under general anesthesia, and is a necessary skill for every
anesthesiologist.

This procedure could typically save someones life.

Typically the patients with more anxiety will undergo endotracheal intubation because it is the most
common and when the anesthesiologist explains this easy procedure, it makes the patient more
comfortable.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237141/

Sunday, November 29, 15

Conclusion

In conclusion, an endotracheal intubation is the most

common because of the accessibility and how quickly it can
be applied. Another reason is because most people will not
experience diculties with endotracheal intubation due to
an accessible oral cavity.

Questions?

Sunday, November 29, 15

Thank You!!!

I would like to personally thank Dr. Wilkes for allowing me

to shadow her on her busy days at work and for allowing me
to see the behind the scenes of the operating room and
pain clinic and for ultimately giving me the opportunity of a
lifetime.

I would also like to thank Mrs. Click for allowing to be in

this program and for giving me this opportunity.

Also, I would like to thank my parents for guiding me

throughout my high school career and helping me become
the person I am today.

And lastly, thank you to the evaluators for taking time out
of their busy schedules to evaluate my project.

Sunday, November 29, 15

Bibliography

"John Sealy Hospital." UTMB Health -. N.p., n.d. Web. 22 Nov. 2015.

Corpus, Angela J. "Endotracheal Tubes." , China Tracheal Tubes Manufacturer. N.p., 23 Mar. 2014. Web. 22 Nov. 2015.

"Below Is a Group Product of Disposable Catheter and Tube." Disposable Catheter and Tube. N.p., 2012. Web. 29 Nov. 2015.

Ivanez, Joesph I. "Medical Degrees Recognition." Medical Schools & Dental Schools in the UK and Abroad. N.p., n.d. Web. 29 Nov. 2015.

Merriam-Webster. Merriam-Webster, n.d. Web. 29 Nov. 2015.

Lancaster, Gina K. "Emergency Manual - Stanford University School of Medicine." Emergency Manual - Stanford University School of
Medicine. N.p., n.d. Web. 29 Nov. 2015.

Bardin, Jon. "General Anesthesia May Disrupt Communication between Brain Areas." Los Angeles Times. Los Angeles Times, 05 Nov.
2012. Web. 29 Nov. 2015.

Howard, Harvey H. "Endotracheal Intubation: Read About This Procedure." MedicineNet. N.p., n.d. Web. 29 Nov. 2015.

"General Anesthesia and Endotracheal Intubation." YouTube. YouTube, n.d. Web. 29 Nov. 2015.

Ramkumar, Venkateswaran. "Preparation of the Patient and the Airway for Awake Intubation." Indian Journal of Anaesthesia. Medknow
Publications & Media Pvt Ltd, n.d. Web. 29 Nov. 2015.

Sunday, November 29, 15