Senin, 21 Februari 2011

Pipe Fitting endotracheal tube (Pet) or intubation

Intubation is the act of maintaining the airway by inserting the pipe through the mouth and nose into the trachea.
ETT installation Benefits:

  1.  Maintenance of airway 
  2. Ensure the provision of oxygen 
  3. Prevent aspiration 
  4. Facilitate the exploitation of mucus or sputum in the trachea. 
  5. Driveway is some kind of resuscitation medicine. 


PROCEDURE
1. Preparation Equipment:


  • - Laryngoscope with blades in accordance with needs 
  • - Margil forceps to help insert pipe ETT 
  • - Mandrain or stylet for ETT curvature memanipulsi 
  • - ETT as needed psien 
  • - Cylocain jelly 
  • - Cylocain spray 
  • - Cup kidney and duk (sterile) 
  • - Gloves 
  • - Drugs in preparation for intubation include sedation (Diprivan, dormicum, relaxan, MO, norcuron) 
  • - Cuff inflator 
  • - Spuit 20 ml 
  • - Gudel or mayo tube 
  • - Stethoscope 
  • - Suction Catheter 
  • - Set suction 
  • - Ambubag + lid 
  • - Hipafix 
  • - Scissors 
  • - Suction wall 
  • - Thin Pillow 

2. Implementation

  • a) Inform and explain (if the patient is conscious) actions to be performed on patients and families 
  • b) Prepare a letter of approval actions to be signed 
  • c) Nurses wash their hands and wear gloves 
  • d) Check kepatenan ETT cuff with 20 ml syringe 
  • e) Put down the sterile cup placed thereon and then apply a sterile kidney Xilocain jelly on the surface of the ETT tip and put mandarin and forcep margil already didesinfektan with alcohol 
  • f) Check and adjust the central suction pressure between 100-200 mmHg and plug it into a sterile suction catheter. 
  • g) Clean the airway mucus by suction (if necessary use mayo) 
  • h) Set the position of the patient in a supine position, head ekstensikan 
  • i) Assist appropriate action intuasi SPO (including the provision of sedation according to doctor's instructions) 
  • j) If successful banging then auscultation in the epigastrium, right and left chest (up-down) 
  • k) If the entry is correct ETT position recharge cuff with syringe 
  • l) ETT fixation with plaster, hipafix according to the depth limit 
  • m) Connect the ETT with oxygen / ventilator required 
  • n) Note the patient's general condition, during and after the act of intubation 
  • o) Measure pressure cuff with cuff pressure (20-30 mmHg) 
  • p) Take the culture if necessary 
  • q) Tidy tool 
  • r) Contact officer for inspection photos radiology thorax 


Complications of intubation Actions

  1.  Injury to the lips and tongue due to pinched laryngoscope 
  2.  Tooth fracture 
  3.  laceration of the pharynx and trachea due Stilets / mandarin and ETT tip 
  4. Damage to vocal cords 
  5. Vomiting and aspiration 
  6. The liberation of adrenaline and noradrenaline intubation due to stimulation resulting in hypertension, and arrhythmias tachikardi 

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