Neonatal intubation made SUPER EASY// Step-by-step instructions!!

Summary

This video tutorial provides a comprehensive guide to intubating babies, focusing on the basic anatomy involved and the techniques used during the procedure. It explains the roles of the trachea, esophagus, vocal cords, and epiglottis in the intubation process. Special attention is given to using a laryngoscope blade to maneuver the epiglottis out of the way to visualize the vocal cords, ensuring safe passage of the endotracheal tube into the trachea. The video also covers positioning, proper blade handling, and the steps for correctly securing the tube once intubation is successful.

Takeaways

• 😀 Understanding anatomy is crucial for successful intubation. The trachea is anterior to the esophagus, and the vocal cords protect the airway.
• 😀 The epiglottis plays a vital role in protecting the airway during swallowing, covering the trachea to prevent food or liquid from entering the lungs.
• 😀 When intubating, the goal is to pass the endotracheal tube (ET tube) through the vocal cords and into the trachea, ensuring proper ventilation of the lungs.
• 😀 The positioning of the baby is important during intubation, with a 'sniffing' position being ideal for ease of access to the airway.
• 😀 Using a laryngoscope or blade is essential for visualizing the vocal cords and getting the epiglottis out of the way.
• 😀 In tiny babies, there's limited space in the mouth, so the blade is used to gently lift the epiglottis and expose the vocal cords for intubation.
• 😀 For older babies, intubation is often performed by lifting the epiglottis from the vallecula, a space directly above it, to reveal the vocal cords.
• 😀 The laryngoscope should be held in the left hand with a firm grip to ensure precision and control when lifting the epiglottis.
• 😀 The blade should be angled at around 60° to the bed to maintain optimal visibility of the vocal cords during intubation.
• 😀 After successfully passing the ET tube through the vocal cords, it should be secured and checked for proper placement, ensuring it's not in the esophagus.
• 😀 Intubation requires practice and experience, so proper technique and positioning are key to successful and safe intubation of a baby.

Q & A

What is the primary goal when intubating a baby?

The primary goal when intubating a baby is to pass an endotracheal tube through the vocal cords and into the trachea, ensuring it reaches the lungs for proper ventilation.

What is the anatomical difference between the trachea and the esophagus?

The trachea is located anteriorly to the esophagus, meaning it is closer to the front of the body, whereas the esophagus is located posteriorly, towards the back.

What role do the vocal cords play in intubation?

The vocal cords act as a barrier that needs to be passed through when intubating. They open and close to allow speech and protect the airway, and the endotracheal tube must be threaded through them to reach the trachea.

What is the epiglottis and how does it affect intubation?

The epiglottis is a small, leaf-shaped piece of cartilage that covers the vocal cords when swallowing to prevent food or liquid from entering the trachea. During intubation, the epiglottis must be moved out of the way to access the vocal cords.

How do you ensure the epiglottis is out of the way during intubation?

To move the epiglottis, the intubator uses a laryngoscope blade. In infants, the blade catches the edge of the epiglottis to lift it, while in older children, the blade is placed in the vallecula above the epiglottis to lift it and reveal the vocal cords.

What is the correct position of the baby’s head during intubation?

The baby should be in a good sniffing position, with the head neither too hyperextended nor the chin pushed toward the chest. This positioning ensures optimal access to the airway.

How is the laryngoscope blade held during intubation?

The laryngoscope blade is held in the left hand using three fingers spaced apart, with the thumb on the opposite side. The pinky finger is used to apply additional pressure (CID pressure) for better control.

What is the correct angle for inserting the laryngoscope blade?

The laryngoscope blade should be held at approximately a 60° angle to the bed when inserting it into the baby's mouth, providing the optimal view of the vocal cords.

What is the significance of the 60° angle during intubation?

The 60° angle allows the laryngoscope blade to properly lift the epiglottis and reveal the vocal cords, enabling clear visibility for intubation. Too flat or too steep an angle may obstruct the view.

How do you thread the endotracheal tube through the vocal cords?

The endotracheal tube should be inserted from the right side of the mouth, threading it through the vocal cords without blocking the view. The tube should be passed until it is correctly positioned, typically about 8 cm for a baby weighing around 2 kilograms.