00:00In this video, we will learn about the preparation and equipments that are needed for intubation and the role of a nurse to ensure that all those equipments are working properly.
00:10The use of each equipment in the process of intubation is explained for better understanding.
00:15On that note, let's get started.
00:18As a standard procedure, first of all, do not forget to take consent for intubation.
00:24IV cannula
00:24Check the patency of the IV cannula or the central line available for pushing the medications during intubation.
00:32If there is any block, place a new IV line for use.
00:36Laryngoscope
00:36Laryngoscope is used to expose the laryngeal inlet under direct vision or line of sight to facilitate placement of tracheal tube beyond the vocal cords.
00:48Check if the blade fits properly with the handle.
00:50Check if the light source is working properly even when the blade is stretched.
00:57Make sure that there are no jiggly parts in the laryngoscope.
01:00The laryngoscope should be sturdy.
01:02Ensure that the bulb is tightly screwed and not jiggling.
01:07Keep two extra pairs of laryngoscope batteries with you which may be useful in case of emergency.
01:14This is laryngoscope handle.
01:15This curved blade of laryngoscope is called McIntosh.
01:20This straight blade of laryngoscope is called Miller blade.
01:25Keep different types and sizes of endotracheal tubes ready like cuffed, uncuffed, subglottic
01:31and any other type of ET tubes as advised by the doctor as needed.
01:37By opening only a small portion of the wrapper of the ET tube, check if there is any leak of ET tube cuff.
01:45Keep a zyloquen jelly ready which is used in a few hospitals to apply at the tip of the endotracheal tube for lubrication before passing it into the trachea.
02:0110 ml syringe to inflate and deflate the ET tube cuff when required.
02:07Ambu bag for ventilating the patient.
02:09Ambu bag and mask should be attached to an oxygen source.
02:12Different sizes of ambu masks which are useful for pre-oxygenating the patient.
02:19Bougie which can be used as a guide wire to easily advance an endotracheal tube into the trachea.
02:28Stylet
02:29Stylet is an instrument which can be used to change the shape of the ET tube the way we want.
02:35Stylet can be used to easily pass the ET tube into the trachea in case of difficult intubation.
02:41Capnometer
02:43Capnometer displays the concentration of carbon dioxide in exhaled air.
02:48It helps in confirming the position of the endotracheal tube.
02:53Loaded and labeled syringes of medications which are used during intubation like
02:58Rucronium, Vecuronium, Fentanyl, Succinylcholine, Propofol, etc.
03:06We must also keep loaded and labeled syringes of emergency drugs ready during intubation which
03:12will come in handy in case of emergencies.
03:14Apparatus for suctioning like suction set, suction catheters, normal saline or sterile water,
03:22central suction apparatus or portable suction apparatus are necessary to clear secretions
03:27and to maintain patency to increase oxygenation during intubation.
03:33ET tie
03:34ET tie for securing the position of the endotracheal tube.
03:44Dynoplaster
03:46Dynoplaster is used to secure the oral airway.
03:50But in some hospitals, dynoplaster is used in place of ET tie for securing the endotracheal tube.
03:58Keep a stethoscope ready for checking the bilateral air entry.
04:01Make sure to arrange personal protective equipment i.e. PPE like cap, face mask, gloves, gown, etc.
04:12for you and all others involved in the intubation process.
04:17Keep ready different sizes of laryngeal mask airway and a tracheostomy kit with different sizes.
04:23These can be used in case of failure to intubate with the endotracheal tube.
04:27Keep a calibrated mechanical ventilator ready with its hose pipe tips properly fitted in its oxygen and air pressure ports
04:37and make sure that the power source for the ventilator and syringe pumps is working properly.
04:43Keep the ventilator tubings, catheter mount, servo guard, HME filter ready
04:49so that we can connect the endotracheal tube to the ventilator after we finish intubating.
04:54Oral airway for use if you suspect the intubated patient may bite the endotracheal tube.
05:02Employing nasal oxygen using a nasal cannula during intubation can prevent hypoxia.
05:08It extends safe apnea time and improves first pass success attempts.
05:13The time period between becoming apneic and oxygenated via intubation is a vulnerable moment in the patient's oxygen status.
05:20This suspected hypoxia can be possibly be reduced by using a nasal cannula.
05:28Magyl forceps
05:29Magyl forceps are used to guide the endotracheal tube into the laryngeal inlet during nasotracheal intubation
05:36or a nasogastric tube into the esophagus under direct vision.
05:41It is also used in the removal of foreign bodies during intubation.
05:45Keep all the colored dustbin within reach to discard the waste.
05:51Ryl's tube
05:51Placing a ryl's tube can prevent aspiration if we do not know when the patient last had food.
05:59Try to label each equipment clearly with capital letters so that it is easy for you to pass
06:04each equipment to the doctor who is intubating according to the sequence of steps involved
06:09in the process of intubation.
06:11So, these are the equipments and preparation that you need to follow before intubation.
06:16If there are any other equipments that you use and any other preparation that you do other
06:22than these please comment below.
06:24If you like this video, don't forget to hit that like button.
06:28Thanks for watching.
06:29Thanks for watching.
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