Intubation Obstacle Course February 2011 CE Condell Medical Center EMS System Site code #107200E - 1211. Prepared by: FF/PM Erich Castillo; Greater Round Lake Fire Department Reviewed/revised by: Sharon Hopkins, RN, BSN, EMT-P. Objectives.
Prepared by: FF/PM Erich Castillo; Greater Round Lake Fire Department
Reviewed/revised by: Sharon Hopkins, RN, BSN, EMT-P
Upon successful completion of this module, the EMS provider will be able to:
1. Describe the airway anatomy in the adult, child and infant populations.
2. Explain the pathophysiology of airway compromise.
3. Review the use of oxygen therapy in cases of airway management in severe situations.
4. Describe the measurement, placement, and assessment of oropharyngeal and nasopharyngeal airways.
5. Explain the value of performing advanced airway procedures.
6. List indications, contraindications, and complications of ET intubation.
7. List equipment required for oral intubation.
8. Explain the rationale for having a suction unit immediately available during intubation attempts.
9. State the time limit for suctioning in the adult, child and infant populations.
10. Describe the methods of choosing the appropriate sized endotracheal tube in an adult, child and infant populations.
11. Explain the rationale for using the stylet during intubation.
12. Describe the proper use of a stylet in orotracheal intubation.
13. Describe the landmarks used with the Macintosh and Miller blades for oral intubation.
14. Describe the skill of orotracheal intubation in the adult, child and infant populations.
15. Describe the steps in confirming endotracheal tube placement in the adult, child and infant patient.
16. Describe the use of the ETCO2 monitor.
17. Describe the use of capnography to monitor patient condition.
18. State the consequence of and the need to recognize unintentional esophageal intubation.
19. Explain the rationale for securing the endotracheal tube.
20. Describe the technique of securing the endotracheal tube in the adult, infant and child populations.
21. Review documentation components of the patient who has been intubated.
22. Demonstrate the skill of measuring and placing the oropharyngeal and nasopharyngeal airways in the adult patient.
23. Demonstrate the skill of orotracheal intubation in the adult patient.
24. Demonstrate confirmation of endotracheal tube placement in the adult patient.
25. Demonstrate the skill of securing the endotracheal tube in the adult patient.
26. Demonstrate the skill of intubation on the adult patient with multiple challenges and multiple obstacles confining the patient (in-line, face to face, in confined space, digital intubation, with a foreign body).
Watch for revisions in oxygen administration guidelines coming to you in the revised SOP 2011
More to follow!
for keeping airway
Check that the tongue was not inadvertently pushed back blocking the airway
Laryngoscope with curved and/or straight blade
(size of little finger for peds)
Extra ET tube – one size up and one size down
10 ml syringe
Method to secure ET tube in placeEquipment Required
ET tube cuff
What does the literature say?
2. King LT-D airway
On patient care report:
Post ET lung sounds
ET Attempt (x___)
Boxes used to indicate crew member activity
Note: Not hard to do, just needs practice!
Imitation: The student repeats what is done by the instructor. In medicine, this is often referred to as, "See one, do one."
Manipulation: The student will use guidelines for skill development, and rely less on the instructor. The student may make mistakes, but correcting mistakes promotes learning. This also allows the student to develop their own style.
Precision: The student has practiced to the point where they don't make mistakes. However, they often can't perform the skill as well in a different setting.
Articulation: The student is able to integrate both cognition and affect into skill performance. They understand why the skill is necessary and when it's indicated. They perform it proficiently and with style. They can perform the skill in multiple settings. This is the phase that students should reach before graduating an initial educational program.
Naturalization: Eventually, the skill is performed without thought. The process has been ingrained into the operator's mind. For example, prior to mastering ETI, a student will reflexively pick up a laryngoscope in their dominant hand (usually right). After mastery, they reflexively pick it up with their left hand regardless of hand dominance.
0505 – 50% Dextrose - 50ml - IV