PROCEDURE SEMINAR GROUP C

INTUBATION
Muhammad Najib Aiman bin Nazeri
2011005
Supervisor : Asst. Prof. Dr. Syed Abdul Khaliq Syed Abd Hamid
 OUTLINE
• Indications
• Contraindications
• Complications
• Equipment
• Methodology
• Videos
WHAT IS INTUBATION ?

• The insertion of a tube into the trachea through oral cavity for airway management

INDICATION

• When bag and mask ventilation or continuous positive airway pressure (CPAP) is insufficient
• For prolonged positive pressure ventilation
• Direct suctioning of the trachea
• To maintain and protect airway
• Diaphragmatic hernia (newborn)
CONTRAINDICATION

• Inexperienced operator in intubation

- Needs to perform bag and mask
ventilation till help arrives
(contraindicated in diaphragmatic hernia)
 COMPLICATIONS
• Esophageal intubation
• Right lung intubation
• Trauma to the upper airway
• Pneumothorax
• Subglottic stenosis

EQUIPMENTS

Bag & mask with high Laryngoscope & Endotracheal tube Stylet (optional)
oxygen flow blades (ETT)

Suction catheter and Pulse oximeter ECG monitoring

Adhesive tape
device
 METHODOLOGY (PRE-PROCEDURE)
1. Position the infant in sniffing position
2. Pre-oxygenation by using bag and mask ventilation
3. Medication (sedation and muscle relaxant)
4. Monitor the child’s vital signs continuously throughout the procedure

METHODOLOGY (PROCEDURE)
1. Introduce the blade between the tongue and the palate with left hand and advance to the back of the
tongue
2. When epiglottis is seen, lift blade upward and outward to visualize the vocal cords
3. Suck secretions if necessary
4. Using right hand, insert ETT from the right side of the infant’s mouth, a stylet may be
required
5. Insert the ETT when the vocal cords are opened till the desired ETT length
6. If intubation is not done within 20 seconds, the attempt should be aborted and
re-ventilate with bag and mask
 METHODOLOGY (POST-PROCEDURE)
1. Once intubated, remove laryngoscope and hold the ETT firmly with left hand
2. Connect the ETT to the self-inflating bag and positive pressure ventilation
3. Confirm the ETT position by looking at the chest expansion and listen to lungs air entry
4. Secure the ETT with adhesive tape
5. Connect the ETT to the ventilator or resuscitation bag
6. Check chest radiograph

VIDEO
 Thank You

References: Paediatrics Protocols for Malaysian Hospital 4th Edition