Endotracheal anaesthesia. No. 5.

The difficulties of blockage during anaesthesia of the larynx. Intubation is shown either orally or nasally depending on where the operation is to be performed. The first section regards Apparatus required; equipment, plaster etc. The preparation of the tubing is demonstrated. Care of endotracheal tubes; an operation finishes. The tube is cleaned by a nurse for re-use. The tube is placed in a hot sterilising unit and it is demonstrated that the metal nasal piece must be removed to prevent permanent enlargement. Preparation of tubes for intubation; the sterilised tubes are removed and lubricated. Preparation of a patient. The anaesthetist sprays the patient s throat with a local anaesthetic prior to intubation. A pillow is placed under the patient s head to get the correct position, which is when the patient looks as though he is sniffing the air . Drawings illustrate this further. Oral intubation; the jaw has to be relaxed and the laryngoscope inserted. Diagrams illustrate its transit. View down the larynx. The tube is inserted into the trachea and then fixed with an adhesive plaster. The mouth is packed with light gauze. Use of the inflatable cuff is shown as an alternative to gauze (it can be inflated in situ). Next the anaesthetic machine is attached. Maintenance of anaesthesia; there are two methods shown; with complex equipment and a simple can of ether used in emergencies. Nasal intubation by the blind method; a drawing demonstrates the correct position of the head. The tube is inserted nasally; this is shown in real time and slow motion to show the care, which the anaesthetist takes when listening to the breath. Nasal intubation by direct vision; the laryngoscope is used again and the tube inserted correctly. Extubation; nasal intubation, suction is used to remove any blood. Advantages of endotrachael anaesthesia; absolute control of the airways. Choking can be prevented. The anaesthetist carefully guards the tubing in complex surgery and can prevent asepsis particularly in surgery to the head and neck. ICI The End.