ENDOTRACHEAL

INTUBATION

ENDOTRACHEAL INTUBATION
It is the placement of a flexible plastic tube into the trachea to maintain an open airway or to serve as a
conduct through which to administer certain drugs.
PURPOSE
 To administer oxygen.
 To remove secretions.
 To ventilate the lungs.
 To establish and maintain airway.
 To treat acute respiratory failure and persistent hypoxemia.

INDICATIONS
 CNS depression.
 Neuromuscular disease.
 Chest wall injury.
 Upper airway obstruction.
 Aspiration prophylaxis.
 Fracture vertebrae and spinal cord.

ARTICLES REQUIRED
 Sand bag/towel roll
 Suction apparatus with tubing.
 Suction catheter
 Ambu bag and mask
 Oxygen source and tubing.
 Laryngoscope with appropriate size blade
 Magill’s forceps
 Endotracheal tube of appropriate size
 Stylette
 Xylocaine jelly
 Plastic syringe 10 ml
 Oral airway
 Cotton tape
 Gloves
 Face mask

PROCEDURE
NURSING ACTIVITY RATIONALE
Identify the patient and explain the procedure to Wins confidence and co-operation from patient.
the patient and relatives.
Raise the head by 5cm with a block or towel roll. To maintain proper position
Position for intubation-position your patient in To maintain proper position
supine position with head extended by keeping
sand bag or towel role under the neck
Hold the laryngoscope with LEFT hand To use correct technique
irrespective of dominant hand
Open the mouth with right hand index finger with To insert endotracheal tube in correct position
support of thumb.
Introduce laryngoscope from right angle of
mouth
 Shift the tongue to left and go in
Press over tongue
See epiglottis and lift it
Watch for vocal cord
Take the tube in right hand
Introduce under vision
To find out correct position of ET tube in the
patient
If tube is inserted, inflate the cuff To fix the ET tube
Connect the source to tube
Confirm placement by auscultation To find out the correct placement of ET tube
Confirm the position of tube.
a) By auscultation
b) By chest expansion
c) By bag movement
fix the tube with adhesive tape To fix the ET tube
connection to ventilate with To check the proper functioning of the ET tube
a. Ambu bag
b. Anaesthesia
machine
c. Ventilator

POST PROCEDURE CARE

NURSING ACTIVITY
Place the patient in lateral position or supine
position
Arrange for chest X ray in order to check
placement of ET tube
Apply endotracheal suctioning as needed
Watch for chest movements, ET tube kinking,
and obstruction, leakage of tube cuff and over
inflation of cuff
RATIONALE
To maintain post procedure position of the patient
To check the correct placement of ET tube
To clean airway
To continue checking of correct position of the
ET tube

COMPLICATIONS
 Tube in oesophagus.
 Endo brachial intubation
 Trauma to lips and tooth
 Laryngeal and tracheal injury
 Baro trauma to lungs
 Bleeding
 Tracheities
 Pulmonary infection and sepsis

CONCLUSION:
Intubation is a common procedure that can be difference between life and death in an emergency. In most
cases a person will fully recover from intubation within a few hours to days and will have no long-term
complications. Intubation is an invasive procedure and can cause considerable discomfort. However,
typically be given general anesthesia and a muscle relaxing medication so that you don’t feel any pain.
With certain medical conditions, the procedure may need to be performed while a person is still awake. A
local anesthetic is used to numb the airway in order to lessen the discomfort.
REFERENCE:
 Sandhya Ghai, Clinical Nursing Procedures, CBS Publisher amnd Distributor Pt. Ltd., 1st edition,
pg. no. 90-94
 Sister Cecy Correia, Principles and Practice of Nursing, Jaypee Brothers Medical Publisher(P) Ltd.
Vol. 2, pg no 151-156.
 Sister Nancy, Principles and Practice of Nursing, Vol 2, N. R. Publishing House, 5TH Edition, Pg.
no. 161-162
 Potter Patricia.A., Perry Anne Griffin, Fundamentals Of Nursing, 5 Th Edition, Mosby
Publications, Page Number 543-546
 The Trained Nurses Association of India, Fundamentals of Nursing, A Procedure Manual, 1st
edition, pg. no. 504-505