Intubation

Question 1

Adult laryngoscope blade sizes?

Answer 1

Mac (or miller) 3 and 4

Question 2

Equipment needed for intubation?

Answer 2

• laryngoscope handle and blade Mac 3 or 4
• Stylet
• ETT one and one size down
• Xylocaine spray
• 10CC syringe, remember to inflate and deflat the cuff to make sure it works
• OPA

ETT

• woman size 7 or 7.5
• men size 8 or 8.5

-spare batteries

Question 3

ETT sizes for adult men

Answer 3

8 or 8.5

Question 4

ETT size for adult women?

Answer 4

7 or 7.5

Question 5

Steps before intubation?

Answer 5

• Correct patient positioning, head and neck positioning to open the airways
• ventilation with 100% oxygen
• Ready of necessary equipment, suction and bagger
• Drugs
• crash cart waiting outside
• Backup plan

Question 6

Examination for difficult intubation?

Answer 6

LEMON

• short neck
• protruding maxillary incisors
• receding mandible
• reduced mobility of neck

Question 7

LEMON: Look

Answer 7

L = look at the patient

• Taller people are easier to intubate
• Evaluate for mobility of mandible and head
• Fro for dental or manipulate trauma, missing teeth etc

Question 8

LEMON: 3-3-2 rule + mallapati?

Answer 8

Question 9

RSI goal

Answer 9

• rapidly intubate patient
• minimize risk of aspiration
• useful for pulmonary aspiration

Question 10

When should the paralytic agent be given?

Answer 10

After induction with sedatives

Question 11

Why should paralytics be given for all intubation?

Answer 11

Prevents regurgitation of the stomach contents

• Relaxes jaw and neck
• Succinylcholine is typically the gold standard for RSI

Question 12

Succinylcholine duration and risks?

Answer 12

Quick duration 5-7 mins

• Depolarizing NMBA, can lead to increased K+
• Contraindicated for hyperkalemia, burn patients, spinal cord injuries

Question 13

Contraindications for Succinylcholine?

Answer 13

• hyperkalemia
• burn patients
• spinal cord injuries

Question 14

Why are RSI’s done?

Answer 14

Patient is spontaneous breathing, if the patient is apneic that its not an RSI

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Question 15

How long should preoxygenation be done

Answer 15

8 mins or asap if patient is apneic

• anxiolytics, benxodiazepine or opioids may be given prior

Question 16

ETT depth for men?

Answer 16

21-13 ATT

Question 17

ETT depth for women?

Answer 17

19-21 ATT

Question 18

Cuff pressure?

Answer 18

Should be 25cmH2O