Endotracheal Intubation

Definition:
Endotracheal intubation (ETT) is place in trachea to maintain airway by invasive ventilation, for anesthesia administration and for other medication.
Indications:

1. It is use in;
2. Breathlessness (Respiratory arrest).
3. Respiratory failure (Type II RF).
4. Any airway obstruction.
5. In traumatized patient for ventilatory support.
6. Shock Patient with poor perfusion (Class III and IV of hemorrhage).
7. Severe chest injury (e.g; Flail chest).
8. Altered mental status in multiple traumas.
9. Protection from aspiration.
10. Swelling in vocal cord due to edema/ erythema.

Precautions:

An operating table use for intubation.

Patient in laying position with pillow below head.

An experienced anesthetic is necessary for intubation.

Personal protective equipment (PPE) are necessary (e.g; gloves, gown and goggles etc).

For intubation patient should be unconscious or give general anesthesia to the conscious patient.

Procedure:

Make the position, open the patient's mouth with hand and jaw with index finger.

Hold laryngoscope in your left hand or non-dominant hand, enter it in patient's mouth.

Take direct it to in line to see epiglottis, glottis and vocal cord for intubation in trachea.

Often an assistant is use to press the trachea to direct view of larynx.

Anesthetic take ETT to enter in trachea with eyes view in optic light with his/her right or dominant hand.

Tube enter from the side of balloon till the end of trachea above 2 cm of Carina.

Inflate the balloon by cuff with syringe full of air.

Confirmation:

1. Anesthetic Confirmed by stethoscope to listen the breaths sound.
2. It can also confirmed by chest x-ray (CXR).

Complications:
ETT intubation can cause edema in trachea.
Bleeding from airway.
Perforation of Tracheal and esophageal.
It also can cause pneumothorax.
Aspiration from lungs.
Also can cause chest pain.
subcutaneous emphysema.