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ENDOTRACHEAL INTUBATION

BY: AIZA

ANATOMY AND PHYSIOLOGY

ANATOMY OF AIRWAY

WHAT IS ENDOTRACHEAL INTUBATION?


Endotracheal intubation is a medical procedure in which a flexible tube is placed into the trachea in order to maintain an open airway in patients who are unconscious or unable to breathe on their own.

INDICATIONS
Airway obstruction Cardiac arrest

Respiratory arrest
Hypoxemia Decreased LOC

CONTRAINDICATIONS

Severe airway trauma or obstruction


Cervical spine injury. DO NOT LIFT THE CHIN.

COMPLICATIONS
Infection Aspiration

Dental injury
Pneumothorax Laryngeal edema Bleeding Tracheal or esophageal perforation

EQUIPMENT:
Laryngoscope

EQUIPMENT:
Laryngoscopic Blade
Adult: Macintosh blade Children: Miller blade

Miller blade

Macintosh blade

EQUIPMENT:
Endotracheal tube

Size of endotracheal tube : internal diameter (ID)


Male: ID 8.0 mms . Female : ID 7.5 mms New born - 3 months : ID 3.0 mms 3-9 months : ID 3.5 mms

9-18 months
2- 6 yrs > 6 yrs

: ID 4.0 mms
: ID = (Age/3) + 3.5 : ID = (Age/4) + 4.5

The size of the tube may also be determined by the size of the patients little finger.

EQUIPMENT:
Endotracheal tube cuff

High volume Low pressure cuff

Low volume High pressure cuff

EQUIPMENT:
Stylet

EQUIPMENT:
Stylet

OTHER EQUIPMENTS
10 ml syringe Lubricating jelly Plaster for strap endotracheal tube Stethoscope Pulse oximeter

POSITION:

Sniffing Position (10 cm elevation)

POSITION:

Sniffing Position (10 cm elevation)

RULES OF INTUBATION
Always have a suction unit available. An intubation attempt should never exceed 30 seconds. Oxygenate the patient pre and post intubation with a bag-valve-mask.(100% O2).

Always recheck tube placement manually guided by oxygen saturation readings.(Spo2).

LARYNGEAL MASK AIRWAY

WHAT IS LARYNGEAL MASK AIRWAY?


Curved, wide-bore tube with a spoonshaped inflatable cuff. It is an alternative airway device used for anesthesia and airway support.
It consists of an inflatable silicone mask and rubber connecting tube.

It is introduced into the hypopharynx to form a seal around the larynx thus permitting positive pressure ventilation without penetration of the larynx or esophagus.

The LMA has proven to be very effective in the management


of airway crisis

INDICATIONS
May be used as a back-up device where endotracheal intubation is not successful. May be used as a second-last-ditch airway where a surgical airway is the only remaining option. Can be used for bronchoscopy in awake patients.

CONTRAINDICATIONS
Morbidly obese patients Obstructed or oropharynx abnormal lesion of the

Greater than 14 to 16 weeks pregnant


Massive thoracic injury Patients at risk of aspiration

SIDE EFFECTS
Throat soreness
Dryness of the throat and/or mucosa Side effects due to improper placement vary based on the nature of the placement

LARYNGEAL MASK AIRWAY

THANK YOU!!!