1.Check equipments - M,E,A,L,S,S,S
Mask - bag valve mask attach to oxygen source
Endotracheal tube with stylet and functioning balloon, determine the size of tube appropriate for the patient.
Airway - artificial airway
Laryngoscope and blade
Syringe 10 cc to inflate balloon
String to fix the tube
Suction
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| Intubation equipments |
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| Checking equipments |
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| Determine size of ET tube |
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| Determine size of ET tube in paediatrics |
2.Put patient in sniffing position, and preoxygenate
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| Sniffing position |
3.Hold laryngoscope with your left hand, open patient's mouth using right hand, introduce laryngoscope into right side of patient's mouth
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| Introducing laryngoscope |
4.Push tongue to left side, slowly advance the blade, then identified arythenoid cartilage, and vocal cord
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| Push tongue to the left |
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E - epiglottis A - arytenoid cartilage |
5. Lift in the direction of laryngoscope handle, apply cricoid pressure
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| Cricoid pressure |
6.Pass the tube on the right side of patient's mouth. Do not allow the tube obstruct the view of the vocal cord
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| Insert tube |
7.Under direct visualization, pass the tube 3 - 4 cm beyond vocal cord
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| Insert tube |
8.Remove stylet and inflate the balloon
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| Inflate balloon |
9.Confirm placement of tube
Direct visualization
CO2 vapor in the tube during each expiration
Chest rise
5 points auscultation
Chest x-ray
10.Fix tube with string
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