Prepare items before tracheal tube
(1) General articles: gloves, masks, aspirators, suction catheter, oxygen, lubricants, syringes, stethoscopes;
(2) General equipment: endotracheal tube, catheter core, dental pad and tape, mask, breathing bag, anesthesia machine and monitor;
(3) Preparation of laryngoscope: Connect the laryngoscope piece to the handle of the laryngoscope, confirm that the connection is stable, and check the brightness of the light source
(4)Check whether the balloon of the catheter is leaking: inject other to make the balloon expand, intact without leakage;
(5) Pre-intubation evaluation: Check the patient's mouth, teeth, mouth opening, neck range of motion and throat to determine whether it is a difficult airway.
The nine steps of tracheal tube intubation
1. Position: a thin pillow is placed on the occipital of the patient, and the three drawing lines of the mouth, pharynx and throat are as consistent as possible;
2. Position: The doctor should stand on the cephalical side and keep enough distance between his eyes and the patient for direct observation;
3. Oxygen: balloon mask "EC method" pressurized oxygen
4. Exposure: the laryngoscope with his left hand, right hand is the patient's mouth open, sending the lens from a patient's right Angle, gradually moved to the central, the tongue body to the left, gently insert the lens barrel to the epiglottis and put the joint, the left side of the straight and forward, up about 45 degrees tyra laryngoscope, see on the edge of the epiglottis, exposed the glottis (angles).
5. Intubation: Hold the medical instrument tracheal tube in the right hand, insert the catheter along the lens from the right corner of the patient's mouth, align the oblique end with the glottis and send the catheter into the trachea, insert the capsule into the trachea, remove the tube core, and continue to send the catheter tip about 22±2 cm away from the incisor teeth.
6. Inflation: Inject air into the air bag, touch the air bag elastic like the tip of the nose, generally inflate 5 ~ 8 mL, no more than 10 mL gas
7. Evaluation: Water vapor was visible on the catheter, simple breathing capsule was connected, and bilateral chest fluctuation was observed by artificial ventilation after squeezing the skin capsule. Symmetrical breath sounds were observed in both lungs by auscultation.
8. Fixation: After confirming that the endotracheal catheter is inserted into the trachea, immediately place the dental pad, and then exit the laryngoscope. Fix the catheter and the dental pad together with the adhesive tape.
9. Examination: the patient's head was reset, bilateral breath sounds were checked by auscultation again, respiratory secretions were sucked out, and ventilator was immediately connected if necessary.