Intubation in Veterinary Medicine

1. Intubation and
Extubation
Drh. Fadeli Bermani, M.Si.

2. What is
Intubation?

3. Make sure all Supplies ready
- Syringe
- Laryngoscope
- Lidocaine 2%
- Syringe to inflate and deflate
tube
- Endotraceal tubes
- Stylet
This also important
- Induction agent (Ketamine, Xylazine or etc)
- Anesthetic inhalation machine
- Patient
- Assistant

4. Syringe
- To inflate and exflate tube
- Usually using 6-12 cc
Sterile lube
- To lubricating tracheal tube
Lidocaine 2%
- To numbing Arythenoid cartilage and
prevent Layngospasm
- Using 1 cc syringe
- Using 0.1 ml volume
Laryngoscope
- Have ready with different size of blade
- Check battery, light bulb

5. Stylet
- If using, make sure stylet not protrude
out the end of tracheal tube
Endotracheal Tube
- Choose the right size

6. Choose the right tube
- Width of the tube should fit between the nostrils (between the Red lines)
- Diameter of the tube same size with nostrils (green circle)
- Palpate trachea (orange)
- Measure tube from canine tooth to thoracic inlet (yellow line)

7. Some refferences

8. Leak Check ETT
1. Fill 10 cc syringe with air
2. Attach syringe to endotracheal tube
3. Fill cuff with air
4. Remove syringe from ETT
5. Observation of leakage

9.  Select proper size ETT
 ETT must be clean
 Measure ETT for proper placement
 Leak check ETT
 Know proper technique to inflate cuff in the ETT
 Know to verify proper ETT placement
 Know how to use laryngoscope
 Know what you are looking at
Before you intubate
Make sure

10. Hold Laryngoscope
Assistant
Hold mouth open (one hand hold
upper jaw)
Dominant hand
Hold ETT
Non- Dominant hand
Hold Tongue
Hold Laryngoscope

11. Basic Anatomy

14. Cat Intubation

15. Make it long enough to tie behind ear and head of patient
Good choices :
IV tubing (prefer for class)
Gauze
Trying tube in place

16. Complications
Trauma to teeth, mucous membrane,
Larynx, pharynx
Tracheal inflammation
Laryngospasm
Inadequate ventilation due too small ETT

17. What is
Extubation?

18. Turn off the anesthetic
 O2 still on and turn off the vaporizer

19. Flush the anesthetic machine
 Disconnect the patient from anesthetic
machine
 Place a thumb over the patient
connection port
 Press O2 flush to fill breathing bag
 Use other hand and squeeze bag to
empty
 Repeat 3 times
 Fill bag with O2 and reconnect
breathing tube to patient

20. Deflate the cuff and loosen tie
 Deflate the cuff ( a good point is when
the HR increase)
 Loosen tie

21. Disconnect from O2

22. Place Patient to Sternal Recumbency
Sternal recumbency allow to
better respiration

23. Remove the ETT
 Don’t remove ETT until the
patient is consciously able to
swallow
 The consciously ability to
swallow will help prevent
aspiration pneumonia if the
patient vomiting