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 

Lid Non-Rebreathing

Lid Non-Rebreathing
- Provides O2 with a flow of 6-12 L / min with 80-100% O2 concentration
- The design looks like the face shield with a rebreathing bag, but the lid has a unidirectional valve between the reservoir bag and the lid on the hole in the side of the lid ekshalasi
- The purpose of the valve is to prevent ekshalasi air into the bag and prevent entry of room air. At the moment of inspiration, the valve on the side of the valve closes and the connection between the bag and the lid is opened, allowing 100% O2 inhalation. At the time of expiration, the valve opens and the side of the valve between the bag and close the lid, increase the release of ekshalasi air out and prevent the entry into the bag.
- The air does not mix inspiration with expiratory air

ADVANTAGES:
O2 Gives 80% for patients with severe hiposekmia
LOSSES:
- Not convenient for patients
- Limitations to eat, drink, cough
- The possibility of inherent valve
- Irritation of the eyes due to high O2 flow rate and the lid that does not fit on the nose
How to Install
- Explain the procedure in patients
- Connect the hose O2 on the humidifier with low flow
- The contents of O2 into the bag by closing the hole between the pouch with a lid
- Adjust the straps tightly closed lid seghingga face and comfortable, if necessary, use a gauze in a depressed area
- Adjust the flow of O2 so that the bag will be filled when the expression and nearly bud at the time of inspiration.