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Artificial Airways Orotracheal Intubation

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Advance tube through the glottis until the cuff passes the ... Step 8: Assess Tube Position (5 cm above carina) Auscultation. Observation of chest movement ... – PowerPoint PPT presentation

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Title: Artificial Airways Orotracheal Intubation


1
Artificial Airways - Orotracheal Intubation
  • RET 2275L
  • Respiratory Therapy Theory Lab 2
  • Module 1.1

2
Orotracheal Intubation
  • Safely performed by
  • Physicians
  • Respiratory Therapists
  • Nurses
  • Paramedics

3
Orotracheal Intubation
  • Step 1 Assemble and Check Equipment
  • Suction Equipment
  • Suction regulator, canister, tubing, catheters,
    Yankauer (tonsil tip)
  • Manual resuscitator bag and mask
  • O2 flowmeter and tubing
  • Laryngoscope with assorted blades
  • Endotracheal tubes
  • Inflate cuff and check for leaks

4
Orotracheal Intubation
  • Step 1 Assemble and Check Equipment
  • Stylet
  • Magil forceps (nasal intubation)
  • Tongue depressor
  • Tape
  • Syringe
  • Lubricating jelly
  • Local anesthetic (spray)

5
Orotracheal Intubation
  • Step 1 Assemble and Check Equipment
  • Towels (for positioning)
  • Stethoscope
  • CDC barrier precaution
  • Gloves, gowns, masks, eyewear

6
Orotracheal Intubation
  • Step 2 Position the Patient
  • Must align the mouth, pharynx and larynx
  • Place one or more rolled towels under the
    patients head

7
Orotracheal Intubation
  • Step 3 Preoxygenate the Patient
  • Provides a reserve of oxygen during intubation
    attempts
  • Intubation attempts should not last greater than
    30 seconds
  • If attempt fails, ventilate and oxygenate for 3-5
    minutes before reattempting to intubate

8
Orotracheal Intubation
  • Step 4 Insert the Laryngoscope
  • Laryngoscope in left hand while right hand opens
    the mouth
  • Insert the laryngoscope into the right side of
    the mouth and move it toward the center,
    displacing the tongue to the left
  • Advance the tip of the blade along the curve of
    the tongue until you visualize the epiglottis

9
Orotracheal Intubation
  • Step 5 Visualize the Glottis

10
Orotracheal Intubation
  • Step 6 Displace the Epiglottis
  • MacIntosh Blade displaces the epiglottis
    indirectly by advancing the tip of the blade into
    the vallecula
  • Miller Blade displaces the epiglottis directly
    by advancing the tip of the blade over the its
    posterior surface and lifting the laryngoscope up
    and forward

11
Orotracheal Intubation
  • Step 7 Insert the Tube
  • Insert the tube from the right side of the mouth
  • Advance tube through the glottis until the cuff
    passes the vocal cords
  • Inflate the cuff to seal the airway
  • Ventilate and oxygenate

12
Orotracheal Intubation
  • Step 8 Assess Tube Position (5 cm above carina)
  • Auscultation
  • Observation of chest movement
  • Tube length (cm to teeth)
  • Colorimetry
  • Capnometry
  • Light wand
  • Fiberoptic laryngoscope
  • Esophogeal detection device
  • Chest x-ray

13
Orotracheal Intubation
  • Step 9 Secure the Endotracheal Tube
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