INTRODUCTION Intubation is required when a patient has difficulty breathing and needs ventilatory assistance. A hollow tube is inserted into the trachea and held in place by a small inflated balloon. INDICATION OF ENDOTRACHEAL TUBE INSERTION ACUTE RESPIRATORY FAILURE CENTRAL NERVOUS SYSTEM DEPRESSION NEUROMUSCULAR DISEASE PULMONARY DISEASE CHEST WALL INJURY UPPER AIRWAY OBSTRUCTION ASPIRATION PROPHYLAXIS FRACTURE OF CERVICAL VERTEBRAE WITH SPINAL CORD INJURY. Equipment required Suction catheter Oxyen, Bag valve mask(Ambu bag) Laryngoscope (two curved blades and straight blade) Stylet /bougie Endotracheal tubes (preferred size and smaller) Magills forceps Drugs (muscle relaxant, sedative) Xylocaine jelly Syringe for cuff inflation Tape to secure tube PROCEDURE Assess the patient’s heart rate, LOC and respiratory status Remove the patient dental bridgework and plates Prepare equipments Complications of intubation Early complications Trauma, e.g. haemorrhage, mediastinal perforation Haemodynamic collapse, e.g. positive pressure ventilation, vasodilation, arrhythmias or rapid correction of hypercapnia. Tube malposition, e.g. failed or endobronchial intubation. Later complications Infection including maxillary sinusitis if nasally intubated Cuff pressure trauma (maintain cuff pressure <25cmH2O) Mouth /Lip trauma

1. ENDOTRACHEAL
INTUBATION

2. INTRODUCTION
 Intubation is required when a patient has
difficulty breathing and needs ventilatory
assistance.
 A hollow tube is inserted into the trachea and
held in place by a small inflated balloon.

3. INDICATION OF ENDOTRACHEAL TUBE
INSERTION
 ACUTE RESPIRATORY FAILURE
 CENTRAL NERVOUS SYSTEM DEPRESSION
 NEUROMUSCULAR DISEASE
 PULMONARY DISEASE
 CHEST WALL INJURY
 UPPER AIRWAY OBSTRUCTION
 ASPIRATION PROPHYLAXIS
 FRACTURE OF CERVICALVERTEBRAE WITH
SPINAL CORD INJURY.

4. ENDOTRACHEAL INTUBATION

7. PARTS OF ET TUBE

8. Equipment required
 Suction catheter
 Oxyen, Bag valve mask(Ambu bag)
 Laryngoscope (two curved blades and straight
blade)
 Stylet /bougie
 Endotracheal tubes (preferred size and smaller)
 Magills forceps
 Drugs (muscle relaxant, sedative)
 Xylocaine jelly
 Syringe for cuff inflation
 Tape to secure tube

9. PROCEDURE
 Assess the patient’s heart rate, LOC and
respiratory status
 Remove the patient dental bridgework and
plates
 Prepare equipments

10.  Position the patient

11. Hold the handle of laryngoscope in the
left hand and hold the patient mouth open
with the right hand by placing crossed
fingers on the teeth.

15. Complications of intubation
Early complications
 Trauma, e.g. haemorrhage, mediastinal perforation
 Haemodynamic collapse, e.g. positive pressure
ventilation, vasodilation, arrhythmias or rapid
correction of hypercapnia.
 Tube malposition, e.g. failed or endobronchial
intubation.
Later complications
 Infection including maxillary sinusitis if nasally
intubated
 Cuff pressure trauma (maintain cuff pressure
<25cmH2O)
 Mouth /Lip trauma

16. PARTS OF TRACHEOSTOMY TUBE

17. THANKYOU