ENDOTRACHEAL INTUBATION Flashcards
what is the two physician consent
if a patient is unable to provide consent in emergency situation you can use a surrogate decision maker
if surrogate can is unable to be contacted two licensed physicians can agree that care should be preformed without consent since delay of obtaining consent could be detrimental to the health of the patient
describe the steps of intubation (10)
- Assess the airway with 1 of 3 methods: mallampati, 3-3-2, or LEMON assessment
- prepare for intubation; gathering all equipment
- place head into sniff position
- hold laryngoscope in your left hand and inset laryngoscope blade into the patients right side of the mouth and displace the tongue to the left
- move the laryngoscope backward and upward to identify the epiglottis and vocal cords
- insert the endotracheal tube through the vocal cords
- inflate the endotracheal cuff with air to provide a seal
- attach oxygen to the endotracheal tube
- ventilate and auscultate the chest b/l
- confirm placement: asucltation of bilateral breath sounds, co2 detector, observe chest rise
describe the 332 rule
this is used to assess if intubation is feasible
3 fingers between the upper and lower teeth with an open mouth
3 fingers between the mental angle and the hyoid bone
2 fingers between the floor of the mandible to thyroid notch
what is the lemon airway assessment
Look externally (facial trauma, large incisors, beard, etc)
Evaluate the 3-3-2
Mallampati score greater than 3 is indicative of difficult
Obstruction (epiglottis)
Neck mobility
indications for airway ventilation/intubation
respiratory failure
apnea
reduced level of consciousness (Glasgow score of 8)
airway injury
risk for aspiration
general anesthesia
contraindications for intubation
laryngeal fracture
what is the sniff position
neck extension and elevation
straight blade:
miller
