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Dr. N.K. Agrawal
Prof, Dept. Of Anaesthesiology,
JNMC, Sawangi.
1
 what is endotracheal intubation?
 what are the indications of intubation?
 equipment required for intubation
 techniq...
 Endotracheal intubation is the placement of
a special tube in trachea
3
 To secure airway
 to supply oxygen
 general Anesthesia
 Cardio pulmonary resucitation
 ventilatory therapy in ICU
4
 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 ( c...
Different sizes of cuffed and plain ETT
6
Laryngoscope
7
Magill’s forceps ( different sizes)
8
Syringe to inflate cuff
9
suction
10
Raise the head by 5cm with a block or ring pillow
11
 Extension at atlanto-occipital joint
 Flexion at neck
12
13
 hold the laryngoscpoe with LEFT hand
irrespective of dominant hand
 open the mouth with right hand index finger with
su...
15
 take the tube in right hand
 introduce under vision
 confirm placement by auscultation
 if tube is cuffed inflate the...
 connect the source to tube
 confirmation
a) by auscultation
b) by chest expansion
c) by bag movement
d) end tidal CO2
...
conection to ventilate with
 ambu's bag
 anesthesia machine
 ventilator
18
- Tachycardia
- rise in blood pressure
- Increase in secretions
- Laryngospasm
- bronchospasm
19
 tube in oesophagous
 endobrocheal intubation
 trauma to lips tooth
 Bleeding
 Leak
 Trachities
 Cough
 sore throa...
 increase in supply of O2
 to give general anesthesia
 improove exhalation of C02
21
It is advisable if the cause is treated
 throat suction
 Laryngoscopy
 Reflexes
 Spo2
 adequate respiration
 level o...
 if mouth opening restricted
 anterior vocal cords
 burn contracture
one may require other options like
 fibro optic i...
Laryngeal mask airway (LMA)
24
Read
it
See
it
Do
it
Learn
it
25
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Endotracheal intubation

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Endotracheal intubation

  1. 1. Dr. N.K. Agrawal Prof, Dept. Of Anaesthesiology, JNMC, Sawangi. 1
  2. 2.  what is endotracheal intubation?  what are the indications of intubation?  equipment required for intubation  technique of intubation  confirmation of intubation  ventilation  complications  extubation 2
  3. 3.  Endotracheal intubation is the placement of a special tube in trachea 3
  4. 4.  To secure airway  to supply oxygen  general Anesthesia  Cardio pulmonary resucitation  ventilatory therapy in ICU 4
  5. 5.  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 5
  6. 6. Different sizes of cuffed and plain ETT 6
  7. 7. Laryngoscope 7
  8. 8. Magill’s forceps ( different sizes) 8
  9. 9. Syringe to inflate cuff 9
  10. 10. suction 10
  11. 11. Raise the head by 5cm with a block or ring pillow 11
  12. 12.  Extension at atlanto-occipital joint  Flexion at neck 12
  13. 13. 13
  14. 14.  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 ît  watch for voccal cords 14
  15. 15. 15
  16. 16.  take the tube in right hand  introduce under vision  confirm placement by auscultation  if tube is cuffed inflate the cuff with syringe 16
  17. 17.  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 17
  18. 18. conection to ventilate with  ambu's bag  anesthesia machine  ventilator 18
  19. 19. - Tachycardia - rise in blood pressure - Increase in secretions - Laryngospasm - bronchospasm 19
  20. 20.  tube in oesophagous  endobrocheal intubation  trauma to lips tooth  Bleeding  Leak  Trachities  Cough  sore throat  barotrauma to Lungs 20
  21. 21.  increase in supply of O2  to give general anesthesia  improove exhalation of C02 21
  22. 22. It is advisable if the cause is treated  throat suction  Laryngoscopy  Reflexes  Spo2  adequate respiration  level of consciousness  extubate 22
  23. 23.  if mouth opening restricted  anterior vocal cords  burn contracture one may require other options like  fibro optic intubatioñ  awake intubation  retrogate intubation  supra epiglotic device 23
  24. 24. Laryngeal mask airway (LMA) 24
  25. 25. Read it See it Do it Learn it 25

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