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Tracheal intubation - 2 Procedure

VOL: 98, ISSUE: 03, PAGE NO: 45

PHIL JEVON, RESUSCITATION OFFICER, MANOR HOSPITAL, WALSALL; JAGTAR SINGH POONI, CONSULTANT IN ANAESTHESIA AND INTENSIVE CARE, CITY HOSPITAL, BIRMINGHAM

PHIL JEVON, RESUSCITATION OFFICER, MANOR HOSPITAL, WALSALL; JAGTAR SINGH POONI, CONSULTANT IN ANAESTHESIA AND INTENSIVE CARE, CITY HOSPITAL, BIRMINGHAM

Tracheal intubation requires expertise and experience. Multiple or failed intubation attempts by inexperienced practitioners may adversely affect the outcome of the cardiopulmonary resuscitation attempt (Resuscitation Council (UK), 2000).

During tracheal intubation, cricoid pressure should be applied if possible. This will help to prevent regurgitation of gastric contents and may make it easier to see the vocal cords. Pressure should not be released until the tracheal tube has been inserted and the cuff inflated, although it should be removed if the patient starts to vomit (Resuscitation Council (UK), 2000).

Tracheal intubation should not exceed 30 seconds (Resuscitation Council (UK), 2000).

Chest compressions can continue during the procedure, but must be stopped briefly if it becomes difficult to see the vocal cords while the tube is being advanced through them.

A number of anatomical and pathological variations can make intubation difficult or indeed impossible. These include a short neck, a stiff neck, prominent incisors, a high arched palate and a narrow mouth (Resuscitation Council (UK), 2000).

Ideally, two people should be available to perform tracheal intubation.

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