Endotracheal Intubation Flashcards
Why do we use intubation?
As anaesthesia removes voluntary control of the airway and protective airway reflexes we need to: Maintain airway Prevent aspiration pneumonia Prevent laryngospasm Reduce environmental pollution Allow IPPV
What equipment is required for intubation?
Suitable sized ET tube (tip of incisor ro spine of scapula) Tube tie Mouth gag Syringe to inflate cuff Lubricant Laryngoscope Local Anaesthetic spray
What types of ET tube are available?
Red rubber
PVC
Silicone
What do ET tubes do?
Link patients airway to anaesthetic machine
Large range of sizes and differing materials
Should be correct length and diameter for patient
Incorrect slection will cause increased dead space
Use of un-cutted tubes in cats recommended
What should be done before intubation?
Ensure tube is correct size
Ensure tube is clean
Ensure cuff is operational
Ensure tube is not damaged
Why are laryngoscope used?
Used to allow better visualisation of the larynx
Consists of light source and blade
May have curved blade
May have straight blade
How do you tell if an ET tube is correctly placed?
Plapate within trachea
Ausculate both lung fields
Observe movement in reservoir bag
check for air movement
What are some disadvantages of using an ET tube?
Increased airway resistance if tube is too narrow
Kinking or occlusion of tube
Latrogenic trauma to larynx
Irritation to mucosa if tube is not rinsed
Over-inflation of cuff can lead to trachea damage
Endo-bronchiol intubation
What can happen if tube is in oesophagus?
What do you do if this happens?
Patient doesn't stay asleep Low SpO2 on pulse oximeter No/ little movement of reservoir bag What to do: Deflate cuff Remove ET tube Re-intubate
What can happen if tube is in bronchus?
What do you do if this happens?
SpO2 greatly reduced Unilateral breath sounds Patient wakes up What to do: Deflate cuff Gently retract tube slowly Re-position and re-inflate cuff
What can happen if tube is blocked/kinked?
What do you do if this happens?
SpO2 low Little movement Cyanosis What to do: Remove and replace with clean tube
What can happen if tracheal rupture occurs?
What do you do if this happens?
Sub-cut emphysema Reduced breath sounds What to do: Deflate cuff Move tube past tear and re-inflate
What should happen on extubation?
Pharyngeal reflexes should return
You should ensure oropharyngeal area is free of debris/blood.
When patient is brachycephalic you should wait for them to cough/chew
