ENDOTRACHEAL INTUBATION

▪    guidance as above
▪    Administer the sedation of choice eg
●    thiopentone 1mg/kg and titrate up to 4mg/kg as essential
OR
●    midazolam 0.1-0.3mg/kg
▪    follow cricoid pressure
▪    Administer neuromuscular blocker (simplest after affected person sedated) eg suxamethonium 1-1.5mg/kg

▪    conserving the laryngoscope within the left hand insert the blade into the affected person's mouth, down the right facet of the tongue and pushing the tongue to the left. Insert down as a long way because the vallecula. Then pull ahead (do not lever at the top enamel)
▪    identify the vocal cords and underneath direct vision , skip the endotracheal tube among the cords and on into the trachea for three-four cm. The tube must degree 21cm at the lips in ladies and 23cm in adult males. remove the introducer.
▪    Inflate the cuff until there is no air leak around it while ventilating.

▪    connect the tube to a bag valve masks attached to oxygen, manually ventilate and
affirm tube placement in trachea by assessing :
●    air entry in axillae
●    SaO2
●    ETCO2 (if to be had), this ought to examine approximately 40mmHg
●    affected person shade
●    ECG
●    BP

▪    If any issues, extubate, reventilate, and reoxygenate with bag valve masks attached to oxygen and re-intubate.
▪    launch the cricoid strain best while the tube placement is confirmed.
▪    Anchor the endotracheal tube firmly with linen tape
▪    Insert a nasogastric tube
▪    arrange a chest Xray to check for endotracheal and nasogastric tube role and for any headaches of the procedure eg pneumothorax.