Endotracheal Tubes Intubation Procedure, ET Tube

Before intubation, preoxygenate the patient with 100% oxygen for 3 to 5 minutes, using a self-inflating bag-mask device with a tight-fitting face mask.
Limit each intubation attempt to no longer than 30 seconds.
After you checked the equipment
Position the patient appropriately.
Non-trauma patient: Place the patient supine with his or her head in a sniffing position whereby the head is tilted and the neck is extended . If necessary, place a small towel under the occiput to elevate it
Suction the patient's oropharynx, if indicated.
Grasp the laryngoscope (with the blade in place and the illuminated light on) in the left hand. Grasp the handle as low as possible, holding it like a hammer in the left hand and keeping the wrist rigid to prevent using the patient's upper teeth as a fulcrum.
Slowly insert the blade into the right side of the patient's mouth, using it to displace the tongue to the left Advance the blade inward and toward the midline past the base of the tongue.
The blade displaces the tongue to the left, which increases observation of the glottic opening.
Advance the blade through the oral cavity to expose the glottic opening. Keep the left arm and back straight when pulling upwardLift the laryngoscope handle up until the vocal cords are clearly visible.
Hold the end of the tube in the right hand with the curved portion downward.
Under direct observation, gently insert the tube from the right corner of the patient's mouth through the vocal cords until the cuff is no longer visible and has completely passed through the vocal cords.
Observe the ET tube passing through the vocal cords to ensure proper placement and prevent intubation of the esophagus.
If all attempts are unsuccessful, the RT should continue to apply proper bag-mask ventilation with 100% oxygen until other options are reviewed.
When the tube is correctly placed, continue to hold it securely in place at the lips with the right hand while first withdrawing the laryngoscope blade and then the stylet using the left hand .
When the ET tube is correctly placed, inflate the cuff.
Maintain cuff pressure between 20 and 30 cm H2O.5
Confirm ET tube placement while manually ventilating the patient with 100% oxygen.
Improper insertion may result in severe hypoxemia, gastric distention, vomiting, and aspiration.
Auscultate over the epigastrium. If air movement or gurgling is heard, esophageal intubation has occurred; pull the tube back and reattempt intubation.
Observe the chest wall for symmetric movement.
Confirm the presence of carbon dioxide using one of these methods:
If the tube is not correctly positioned, deflate the cuff and remove the tube immediately. Ventilate and oxygenate the patient with 100% oxygen for 3 to 5 minutes and then reattempt intubation.
Confirm the correct tube position via a chest radiograph per the organization's practiceFor difficult intubation you might consider bougie and the use a video laryngoscope, if available.

[@walterestrada9523]

Great video . Thanks .greeting from Miami Florida .

[@clarkkent4872]

Thank you for detailed explanation

[@margaretnaveen8085]

Thanks for the video

[@garyseeseverything8615]

Very informative thank you!

[@Ahmed-pp7sv]

دكتور ممكن تشرحنه على سفلاين cv line

[@user-jx7uy8fn5s]

So good 😀 thanks

[@puiman5566]

thank you very much
😘

[@sarahharbawi4008]

ممتاز 👍🏻👍🏻

[@MissDrew.]

👍

[@rwe1712]

هذا في التمريض او العلاج التنفسي؟

[@criticalrnskills5326]

وحسب سياسة كل مستشفىدور التمريض تجهيز الادوات والادوية اللازمة