Nursing Care

NURSING CARE IN
ENDOTRACHEAL
INTUBATION
NURSING CARE IN PATIENTS SUBJECTED TO
INTUBATIONENDOTRACHEAL
It is the care that nursing provides to the patient who will undergo
endotracheal intubation.
GOALS:
1.Provide nursing care with quality and warmth to the patient undergoing
endotracheal intubation, to improve oxygenation
tissue and reduce complications
2 .Maintain assisted ventilation of the patient.
3 .Facilitate aspiration of secretions from the bronchial tree.
4 .Reduce post-procedure risks and/or complications and avoid
aspiration.
ENDOTRACHEAL NTUBATION ASSISTANCE
NURSING
THE PARTICIPATION OF NURSING IN THE PROCEDURE

BEFORE AND DURING THE PROCEDURE
2. LATER ARE THE NURSING CARE
TO THE NEED FOR OXYGENATION CONVENTILATION
1. MEDICAL
ASSISTANCE
PARTICIPATION BEFORE INTUBATION
• Preparation of material and equipment
• Prepare the medications indicated for
intubation Prepare the arrest cart
• Check the operation of the O2 intakes
and air.
Prepare the vacuum cleaner.

Transfer to patient unit
Material for endotracheal
intubation
•Laryngoscope with batteries.
•Laryngoscope blades of various sizes.
•Magill forceps. •Aspiration probes.
•Medication for analgesia,
Guides or guarantors. sedation and muscle relaxation.
•Sterile gloves. •Vaccum cleaner.
•Stethoscope.
Endotracheal tubes of various •Ventilation bag (ambu type) with
sizes. mask.
•Anesthetic lubricant. •Complete oxygen equipment.
•Anesthetic spray.
•10 ml syringe.
•Fixing tape and adhesive sponge.
Material for
endotracheal
intubation
cannula
Endotracheal
„ intubation
a P the nurse in
Patient activities
1. Verification of operability of materials and equipment.
PRE PROCEDURE
Transfer material and equipment to the patient unit
2.Have various calibers of endotracheal tubes
3.Assess if there are false teeth in the patient
4.Place the patient on a flat surface, Tilt the head back
but not hyperextended.
Elevate your shoulders with a rolled sheet.
PRE PROCEDURE
5. Oxygenate the patient with positive pressure
ventilation 6. Administration of sedative and relaxing
medications according to medical indication.
Because the patient will be subjected to a procedure
that causes a brief period of apnea, with the risk of
respiratory arrest. To produce sedation and facilitate
rapid placement of the endotracheal tube.
Participation in intubation
1 . The nurse assists the intubator as follows: Stabilize the head,

support if necessary.
2 . Provide the equipment to the doctor:
Laryngoscope, Intubation tube.
3 . Provide positive pressure oxygen if necessary.
4 .Perform aspiration of secretions
5 The doctor starts the intubation
6 .Medicines are applied at the time indicated by the doctor
The collaboration of an assistant with knowledge of the procedure and experience is essential for
the procedure to be a success. Intubation requires a lot of practice and skill, and this technique
should be carried out only by qualified personnel.
7.After completing intubation:
• Aspirate secretions from tube and trachea. Aspiration should be
done using sterile technique.
• Verify proper placement of the endotracheal tube
• Secure the tube with tape and ties around the
patient's neck
• The probe should be connected to a source of humidified oxygen
or a mechanical ventilator.
Aspiration of the endotracheal tube allows access to the
tracheobronchial tree. If the tube is in the esophagus, it inflates the
stomach, and aeration measures have no useful effects on the lungs.
If it is inserted too far into the lungs, it may penetrate the bronchus.
Coughing or movement of the patient make the tube
move if not fixed The nose serves the function of warming and
humidifying the inspired air
Secure the If a device is not
endotracheal tube An endotracheal available you can tape
to the patient's tube holder should cloth tape or
head be used endotracheal tube
tape.
Check the time and notify the intubator of the time used
in each attempt.
Check heart rate. Respiratory effort and patient color
Assist with bag and mask ventilation when necessary
Maximum intubation time is 20 seconds To monitor the
patient To stabilize the patient during intubation attempts
1 POST -PROCEDURE:
. Check the position of the tube in turn, auscultating both
lung fields
2 . Change the fixation and support points of the tube
periodically to avoid decubitus.
3 . Mark the level of the labial commissure on the tube
with a marker.
To prevent displacement that can occur due to patient it
movements
To avoid skin and oral corner injuries To demonstrate
maintenance of correct tube placement
POST -PROCEDURE:
4 .Aspirate secretions when necessary.
5 .Hygiene the mouth with a mouthwash, the nose with
physiological saline and moisturize the lips with Vaseline
every 8 hours, or more if necessary.
6 .Manipulate the tube in the different maneuvers with
strict asepsis. Thus avoiding obstruction of the ETT. To
avoid dryness of the oral mucosa 7. Make notes on the
clinical record sheet.
8 .Leave the patient and their unit comfortable and clean
9. Satinize the equipment used
COMPLICATIONS
A. Immediate: most occur during intubation: Direct
trauma
Suction tube malposition.
Pneumothorax due to barotrauma
Cuff hyperinflation
Laryngeal reflexes, which can cause laryngospasm
Hemorrhages and blockages due to poor care of the
tube.
Dysphagia and post-extubation aspiration.
Tracheoesophageal perforations.
Self-extubation.
COMPLICATIONS
B. Late:
Granulomas and scars on the vocal cords.
Ulcerations.
Laryngeal rings.
Laryngeal chondritis (stenosis).
Tracheomalacia (stenosis).

Nursing Care

Uploaded by

Copyright:

Available Formats

Nursing Care

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Nursing Care

Uploaded by

Copyright:

Available Formats

NURSING CARE IN

THE PARTICIPATION OF NURSING IN THE PROCEDURE

2. LATER ARE THE NURSING CARE

TO THE NEED FOR OXYGENATION CONVENTILATION

• Preparation of material and equipment

• Prepare the medications indicated for

intubation Prepare the arrest cart

• Check the operation of the O2 intakes

Prepare the vacuum cleaner.

1 . The nurse assists the intubator as follows: Stabilize the head,

You might also like