Endotracheal Intubation

INDICATIONS:
Airway protection
o Loss of gag reflex eg severe head injury
o Airway obstruction eg acute laryngeal edema (inhalational
burn, epiglotitis, etc)
o Anticipated loss control of the airway eg anticipated
laryngeal edema (neck trauma)
Needs for mechanical ventilation
o Loss of ventilatory drive: stroke, brain injury
o Spinal cord injury
o Myastenia gravis
o Flail chest, obesity
o Acute lung injury
Operation procedure
o Ventilation perfusion mismatch (pulmonary embolism,
emphysema)
o Inability to extract at cellular level (severe sepsis, cyanide
or CO poisoning)

EQUIPMENT:

PREDICTING DIFFICULT INTUBATION:

PROCEDURE:
Laryngoscope held with left hand
Open patients mouth insert blade to right side of oropharynx
The tongue swept to the left and up into the floor of pharynx by
the blade
The tip of curved blade is usually inserted to vallecula, while
straight blade to cover epiglottis
The handle of the blade then raised up and away from the
patient in a plane that perpendicular to patients mandibule
Insert the endotracheal tube, remove the stylet
Use the ambu-bag to see the tube is correctly placed or not