Operational Medicine Medical Education and Training

Intubation Review

Advantages of tracheal intubations:

Airway patency

Protects the airway

Maintains patency during positioning

Control of ventilation

ventilation over a long period of time without intubation can lead to gastric distention and regurgitation

Advantages of tracheal intubations:

Route for inhalation anesthesia and emergency medications

N - Narcan

A - Atropine

L - Lidocaine

E - Epinephrine

ET Tube in Place

Intubation Review

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Endotracheal Intubation Visualizing the Epiglottis

Complications of tracheal intubation:

Trauma to the lips, teeth, and soft tissues of the airway.

Awareness

meticulous technique

Bronchial intubation

frequent complication

auscultation of the chest bilaterally

Complications of tracheal intubations:

Laryngospasm

common when extubation is done when the patient is in a semiconscious state

extubation should be done in a relatively deep anesthesia or when the protective laryngeal reflex has returned

Postintubation hoarseness and sore throat

due to mechanical presence of the tracheal tube

Preparation of Equipment

Assemble pharyngeal airways in assorted sizes

Nasopharyngeal

Oropharyngeal

Inspect laryngoscope for serviceability

Batteries

Light bulb

Blades; curved/straight (Macintosh or Miller)

Selection of laryngoscope blade (preference)

Macintosh is a curved blade whose tip is inserted into the vallecula (the space between the base of the tongue and the pharyngeal surface of the epiglottis). Most adults require a Macintosh number 3 or 4 blade.

Selection of laryngoscope blade (preference)

Miller is a straight blade that is passed so that the tip of the blade lies beneath the laryngeal surface of the epiglottis. The epiglottis is then lifted to expose the vocal cords. Most adults require a Miller number 3 blade.


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From SFC Hill

Joint Special Operations Medical Training Center

In

Operational Medicine 2001

Bureau of Medicine and Surgery

Department of the Navy

 

 

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