Endotracheal Intubation

NEONATAL FLOW ALGORITHM BIRTH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Evaluate respiration heart rate and color Give supplementary oxygen Observational Care Provide positive-pressure ventilation* Post-resuscitation care ,[object Object],[object Object],[object Object],Administer epinephrine and/ or volume* * Endotracheal intubation may be considered at several steps HR <60 HR <60 HR >60 Persistent cyanosis Effective Ventilation, HR>100 & Pink Pink Breathing, HR>100 but cyanosis Breathing, HR>100 & Pink Yes No Apneic or HR <100 Approximate Time A B C D 30 sec 30 sec 30 sec

Indications for intubation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Preparing laryngoscope ,[object Object],[object Object],[object Object]

Selecting endotracheal tube ID=Internal Diameter > 38 wks >3000 gm 4.0 (ID mm) 35-38 wks 2000-3000 gm 3.5 (ID mm) 28-34 wks 1000-2000 gm 3.0 (ID mm) < 28 wks <1000 gm 2.5 (ID mm) Gest. Age Weight Tube Size

Preparing endotracheal tube ,[object Object],[object Object],[object Object]

Additional items ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Positioning the infant ,[object Object],[object Object]

Visualizing the Glottis with Laryngoscope ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tip to lip distance (6+wt. in kg) 9 cm 3 kg 8 cm 2 kg 7 cm 1 kg Distance Weight

Confirming ET tube placement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tube in Rt. Main bronchus ,[object Object],[object Object],[object Object],[object Object]

Tube in esophagus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Three actions after intubation ,[object Object],[object Object],[object Object]

Complications of intubation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Minimizing hypoxia during intubation ,[object Object],[object Object]

LMA – its role in neonatal resuscitation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Endotracheal Intubation

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Endotracheal Intubation