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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Magills 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 t
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 intubatio
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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