Taking someone's airway is sometimes necessary but comes with inherent risks.
Having an Intubation checklist that you and your team can use will improve success rates and minimize complications.
DECISION:
Understanding the correct time, location, and patient to Intubate takes experience and understanding.
QUESTIONS:
1. Can we resuscitate prior to Intubation?
2. Can we wait until the OR to Intubate in a controlled environment?
3. Intubate prior to pain control?
4. Intubate for oxygenation, ventilation, not protecting the airway, pain control, and dangerous/combative patient, among other reasons.
PATIENT PREP:
1. Position patient
2. Preoxygenate/denitrogenate
3. Multiple access points
4. Monitoring (EtCO2, Defib pads, Vitals, Updated BP, etc.)
5. Consent, if possible
6. Assess the airway
EQUIPMENT:
1. BVM connected to O2 + Peep valve
2. NPA/OPA
3. Suction- This is often forgotten.
4. Bougie & Stylet
5. ETT (multiple sizes)
6. Syringe/check cuff
7. EtCO2/ CO2 detector
8. Securing device
9. Backup Airway like an iGel, LMA, etc.
10. Cric kit+ marked neck if high risk
11. Ventilator and RT ready
12. Medications/RSI drawn and closed-loop communication
13. PPE for all involved
14. Stethoscope
POST INTUBATION:
1. Sedation/pain control
2. Vent settings
3. Chest x-ray
4. Patient restraints, if needed
5. Foley and OG/NG
6. Pressors/adjunct drips
7. Central line?
Do you have a checklist and routinely practice or use it for Intubations?
Information from @the_resuscitationist
Disclaimer: This post is for educational purposes and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.
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