Airway Management + Intubation

 

  • WIPE, blah blah 🙂
  • Take consent
  • Assess airway: to check if the pt is expected difficult to ventilate \ intubate
    • Vital signs
    • Look: beard, teeth, tongue size, signs of obstruction (stridor), foreign body
    • Evaluate: 3-2-1 rule
    • Mallampati score
    • Neck mobility
  • Check equipment:
    • Blade (mac size 3 for adult)
    • Ambu bag + face mask
    • Suction
    • ET (size; female 6-7, male 7-8) + working cuff (inflate it to check)
    • Mention you might need a cart for suspected difficult to intubate patients
  • Pre-oxygenate:
    • Use ambu bag + face mask
    • “CE” position + chin lift \ head tilt
    • For 5 minutes (3 mins at O2 sat 100%)
  • Intubate:
    • Sniffing position: upper neck extension + lower neck flexion
    • Hold blade in left hand, ETT in right hand
    • Slide the blade, sweep and lift tongue up, go until you see the epiglottis \ vallecular space
    • Pass the ETT through the vocal cords
    • Remove blade
    • Inflate the cuff
    • Fix the ETT to the mouth
    • Connect to the machine
    • Ventilate
  • Confirm the ETE is in the right place:
    • Direct visualization of the ETT passing through the vocal cords
    • Fogging of the ETT upon ventilation
    • Symmetrical chest expansion
    • Auscultation (the 5 areas)
    • Capnograph (end-tidal CO2)
    • CXR

 


Download the PDF version: here

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