ENDOTRACHEAL

TUBE

PAEDIATRIC DEPARTMENT
Nepalese Army Institute Of Health Sciences
 DESCRIPTION
 Sterile, ready to use, disposable, translucent
PVC made with radio opaque marker and
adapter at the proximal end.
 INDICATIONS
 Upper respiratory tract obstruction
 Mechanical ventilation
 Loss of protective airway reflex (in coma,
paralysis of respiratory muscle etc)
 Need for high peak inspiratory pressure
 Administration of general anesthesia.
 Inadequate CNS control of ventilation
 Tracheal clearance in MAS
 DRUGS THAT CAN BE GIVEN
ENDOTRACHEALLY

 Epinephrine
 Naloxone
 Atropine (LANES)
 Lignocaine
 Surfactant
 SIZE OF ETT
 NEWBORN:
Expected gestational age divided by 10.

ID (mm) WT (kg) GA (weeks)

2.5 <1 28

3 1-2 28 – 34

3.5 2-3 34 – 38

4 >3 >38
 TWO YEARS: 5 mm
 > 2 YEARS:
Age in years
------------------ + 4 = ID
4

 length:
 Weight in kg + 6

 ID x 3
 TYPES OF ETT
 Uncuffed ( in children under 8 years as
normal anatomic narrowing at the level of
cricoid cartilage acts as functional cuff)

 Cuffed
 INTUBATION PROCEDURE
 Place the baby with neck slightly extended
position.
 Stand at head end of the baby
 Hold the laryngoscope in left hand with
blade pointed away.
 Introduce the laryngoscope blade in mouth
between baby tongue and palate.
 Advance the tip of blade just beyond the
base of tongue.
 Lift the blade in direction of handle of the
laryngoscope.
 You will see the glottic opening just below
epiglottis, mild pressure over trachea by
little finger lowers the trachea and glottis
will be seen clearly.
 Hold ETT in right hand and insert from the
corner of mouth until vocal cord guide is at
the level of vocal cord, tip should be 1.2 cm
above carina.
 All these procedure should be completed in
20 seconds to avoid hypoxia.
 Hold the ETT with right hand and remove the
laryngoscope.
 See the signs of correct ETT placement:
Bilateral equal breath sounds
Chest movements
No sound on epigastric area
Radiology
Improvement in heart rate and color

 Secure the ETT with tape.

 COMPLICATIONS
 Hypoxia
 Bradycardia
 Apnea
 Pneumothorax
 Injury
 Infection
 Obstruction

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