Intubation 시술간호

Summary

This video provides a detailed guide on intubation procedures, including preparation and execution. It covers the necessary equipment, such as endotracheal tubes, laryngoscopes, and video scopes, and explains techniques for ensuring proper tube insertion and patient safety. The script emphasizes testing equipment, patient positioning, and cuff management, as well as the importance of securing the tube and confirming correct placement with monitoring tools. A comprehensive step-by-step approach is outlined for healthcare professionals to perform intubation with precision and care.

Takeaways

• 😀 Ensure all necessary equipment is prepared before starting the intubation procedure, including ET tubes, Ambu bag, and laryngoscope.
• 😀 Conduct a leak test on the Ambu bag by covering the patient end and squeezing to check for air leaks.
• 😀 Perform a function test to confirm that the Ambu bag's membrane is properly opening and closing during bagging.
• 😀 Choose the appropriate size for the ET tube: 7.5-8mm for adult males and 7-7.5mm for adult females.
• 😀 Use a metal or disposable stylette carefully when inserting the ET tube to avoid damage and ensure it does not bend unnaturally.
• 😀 Verify patient identity and explain the procedure before starting, ensuring proper consent is obtained.
• 😀 Position the patient in the 'sniffing position' by tilting the head back and flexing the neck to facilitate intubation.
• 😀 Inflate the ET tube cuff carefully, checking for leaks, and replace the tube if necessary.
• 😀 After tube insertion, confirm correct placement using chest auscultation and ETCO2 monitoring to ensure proper ventilation.
• 😀 Use a cuff pressure monitor to ensure the ET tube cuff is inflated to a safe pressure range (22-32 cm H2O).

Q & A

What is the main purpose of intubation in this procedure?

The main purpose of intubation is to secure the airway, ensure proper oxygenation, ventilation, and the removal of secretions by inserting an endotracheal tube into the trachea.

What items are required for the intubation procedure?

The required items include a clean sheet, endotracheal tube, ambu bag, airway 10cc syringe, airway securing tape, laryngoscope or video scope, blade cover for video scope, stethoscope, and stylets.

How is the functionality of the ambu bag and m900 device tested?

The functionality is checked through a leak test and a function test. The leak test involves blocking the patient's airway and ensuring there are no leaks when the ambu bag is squeezed. The function test ensures that the membrane of the ambu bag opens and closes properly when bagging.

What is the proper method for assembling the laryngoscope?

To assemble the laryngoscope, the blade and handle are aligned and fixed into place. After assembly, check that the light at the end of the blade is functioning.

How is the video scope setup?

For the video scope, the monitor and blade are assembled, and the monitor is powered on to ensure the screen and light are functioning. Afterward, the blade cover is attached to the video scope.

How do you select the correct size of the endotracheal tube?

For adult males, the correct size is typically between 7.5 and 8mm, and for adult females, it is between 7 and 7.5mm. The tube size can also be estimated based on the patient's anatomy.

How is the cuff tested for the endotracheal tube?

The cuff is inflated using a syringe, and any leaks are checked. If the cuff is inflated properly, any excess air is removed.

What is the role of the stylet in intubation?

The stylet is used to assist in inserting the endotracheal tube into the trachea. It is carefully placed inside the tube, ensuring that the tube is shaped correctly for smooth insertion without damaging the mucosa.

What is the procedure for fixing the endotracheal tube in place after insertion?

After inserting the tube, the position is confirmed, and the tube is secured with adhesive tape or a fixation device. The tape is wrapped around the patient's face, starting from one side of the cheek to the upper lip, ensuring the tube stays in place.

How is the pressure in the endotracheal tube cuff monitored?

The cuff pressure is checked using a cuff pressure gauge (cuff pressure tester) and should be within the range of 22 to 32 cm H2O. If the pressure is low, the pump is used to inflate the cuff, and if it is too high, the pressure is reduced by pressing a red button.