- Look general condition. Good, or bad, and the consciousness. Ask history of asthma, allergies, hypertension, diabetes mellitus, convulsion, prolong therapy of tuberculosis.
- Examine “the ABCD” Airway: clear or unclear (any discharge, debris, blood, etc) Breathing: respiratory rate, pattern of breathing, additional sounds (wheezing, ronchi) Circulation: blood pressure, heart rate (regularity, quality), additional heart sounds Dissability: consciousness (GCS), pupil light reflex, pupil diameter, pupil isokor/anisokor
- Do appropriate supporting examines: laboratorium, X-ray photos, CT Scan, etc.
- Assess the patient condition with ASA criteria
- Is the surgery being elective or emergency ? Be careful in emergency patient. All emergencies patient is full stomach, so they need special tecnique, such as rapid induction/intubation, do Sellick manuever, set the nasogastric tube.
- There is no best anesthetic agent/technique but only best anestetician. Good luck
How to perform intubation ?
- Prepare the instruments: endotracheal tube (ET), laryngoscope, tapes, stetoscope, spuit cuff, suction unit.
- Check the light of laryngoscope.
- Perform triple manuevers: jaw trust, neck extension, chin lift
- Get the laryngoscope left handled, open the mouth, start from the right edge of mouth until middle tongue get the blade of laryngoscope until find eppiglottis and than plica vocalis under the epiglottis. If there is any debris, than suction
- Enter the ET to the laryng.
- Check the pulmo sound with stetoscope, right and left must be the same. If harder than another pull out until have the same sound.
- Fixation the ET with cuffing the ballon, plaster the ET pipe on the mouth.
- Connect to the breathing equipment If you have any question, or advise, please do not hesitate to contact me at this comment below
