| Term | Definition |
| Intubation
Step:1 | Position Patient Head in sniffing position slight hyperextension |
| Intubation
Step:2 | Adequately hyperoxygenate (resuscitation bag with 100% for 2 minutes |
| Intubation
Step:3 | Hold laryngoscope in left hand
ET Tube in right hand |
| Intubation
Step:4 | Insert blade down the right side of the mouth, sweep tongue to the left. |
| Intubation
Step:5 | Advance blade, lift epiglottis visualize vocalcords,
(curve blade tip) = vallecula
(straight blade tip) = epiglottis
have suction available |
| Intubation
Step:6 | Cricord Pressure = (Selleck Maneuver)
is indicated if the larynx is in an anterior location |
| Intubation
Step:7 | Insert tube, inflate cuff, assess tube position, ventilate, and oxygenate |
| Minimal Occluding Volume
(MOV) | technique used to inflate cuff = 20-25 mmHg/25-30 cmH20
listen for air leak as cuff is inflated during positive pressure ventilation: STOP inflating at minimum volume necessary to eliminate air leak via trach or ET Tube |
| Minimal Leak Technique
(MLT) | slowly inject air into the cuff during positive pressure inspiration until leak STOPS;
A small amount of air is removed to allow a slight leak during peak inspiration.
Remove the small amount to PREVENT aspiration |
| Assessment Of Tube Position
Notice Sequence | 1. Inspection
(look for bilateral chest expansion during inspiration)
2. Auscultation
(breath sounds should be heard bilateral)
3. Capnography
(CO2 Detector)
4. Chest X-ray
( tip of tube 2cm or 1 in ABOVE carina or at aortic knob/notch |
| Tube Maintenance
Suctioning | Maintain patency |
| Tube Maintenance
Humidification | * Prevent dehydration of tissue (100% Humidity @ 37.C)
* Best way to prevent obstruction |
| Tube Maintenance
Cuff Pressure | *Minimal leak
*Minimal occluding volume
*Use high volume/low pressure cuff =to or< 20mmHg) |
