for teaching students

1. Dr. N.K. Agrawal
Prof, Dept. Of Anaesthesiology,
JNMC, Sawangi.
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2.  what is endotracheal intubation?
 what are the indications of intubation?
 equipment required for intubation
 technique of intubation
 confirmation of intubation
 ventilation
 complications
 extubation
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3.  Endotracheal intubation is the placement of
a special tube in trachea
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4.  To secure airway
 to supply oxygen
 general Anesthesia
 Cardio pulmonary resucitation
 ventilatory therapy in ICU
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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
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6. Different sizes of cuffed and plain ETT
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7. Laryngoscope
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8. Magill’s forceps ( different sizes)
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9. Syringe to inflate cuff
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10. suction
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11. Raise the head by 5cm with a block or ring pillow
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12.  Extension at atlanto-occipital joint
 Flexion at neck
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13. 13

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
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15. 15

16.  take the tube in right hand
 introduce under vision
 confirm placement by auscultation
 if tube is cuffed inflate the cuff with syringe
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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
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18. conection to ventilate with
 ambu's bag
 anesthesia machine
 ventilator
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19. - Tachycardia
- rise in blood pressure
- Increase in secretions
- Laryngospasm
- bronchospasm
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20.  tube in oesophagous
 endobrocheal intubation
 trauma to lips tooth
 Bleeding
 Leak
 Trachities
 Cough
 sore throat
 barotrauma to Lungs
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21.  increase in supply of O2
 to give general anesthesia
 improove exhalation of C02
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22. It is advisable if the cause is treated
 throat suction
 Laryngoscopy
 Reflexes
 Spo2
 adequate respiration
 level of consciousness
 extubate
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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
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24. Laryngeal mask airway (LMA)
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