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INDICATIONS FOR ENDOTRACHEAL INTUBATION

Inadequate ventilation, whether due to sedation and neuromuscular paralysis in the operating room, an obstructed or compromised airway, altered mentation, loss of consciousness, or respiratory failure can lead to brain injury or death within minutes. It is, thus, of great importance to know how to evaluate and address a patient who may require ventilatory support. INDICATIONS FOR ENDOTRACHEAL INTUBATION Indications for ENDOTRACHEAL INTUBATION in the operating room include: the need to deliver positive pressure ventilation, protection of the respiratory tract from aspiration of gastric contents, surgical procedures involving the head and neck or in non-supine positions that preclude manual airway support, almost all situations involving neuromuscular paralysis, surgical procedures involving the cranium, thorax, or abdomen, procedures that may involve intracranial hypertension. Some non-operative indications are: profound disturbance in consciousness with the inability to protect the airway, tracheobronchial toilet, severe pulmonary or multisystem injury associated with respiratory failure, such as sepsis, airway obstruction, hypoxemia, and hypercarbia. Objective measures may also be used to help determine the need for intubation: respiratory rate > 35 breaths per minute, vital capacity <>

STATICS ! Don’t forget it before intubation

Before intubation, please prepare this STATICS S is Scope, this is for stetoscope, laryngoscpe with bright lamp. T for Tubes. Choose an appropriate size. For adult or children. A for Airway device. It’s call Mayo or Guedel. This uses to prevent falling tongue. T is Tape. Don’ forget to this simple device. You can’t fixation an ET without this. I is Introducer. You can say “it is stylet for making intubaation easy” C for Connector to connect tube and anesthesia machine. S is Suction. Suction the mucus or saliva Oke ! See You..

Anesthesia in Meulaboh Aceh

Since July 27th 2007, I have asked to do anesthesia in Cut Nyak Dien hospital Meulaboh Aceh. My first patient was a woman who will performed sectiocesaria. The anesthesia technique was regional anesthesia, especially sub arachnoid block, with marcain spinal, at lumbal space III-IV. This technique has advantages compare with general technique, because it's not affect respiration and consciousness. I hope during my job in Aceh will having success until I come home one month later.

What types of anesthesia are available?

You will have one of three kinds of anesthesia during surgery. Monitored anesthesia care (MAC) is often used for surgery that is short and does not require the surgeon to cut muscle or bone. Sedatives and pain killers are given through an IV. The area around the surgical site is numbed with a local anesthetic. You may choose to remain awake or sleep lightly. If you are uncomfortable, your anesthesiologist can usually make you sleepier or the surgeon can inject more local anesthesia. Regional anesthesia is often used for surgery on the arms, legs, lower abdomen and during childbirth. A local anesthetic is injected to block nerve impulses in a nerve or group of nerves coming from the site of the surgical procedure. The area will begin to feel numb within minutes. Sedatives are typically administered through an IV catheter. With regional anesthesia, you may remain awake or choose to sleep lightly. General anesthesia is most often used for more extensive surgery, such as abdominal, heart, brain or chest surgery. You are unconscious throughout the surgery.

In certain situations a combination of general and regional anesthesia may be appropriate.

Following your pre-anesthetic evaluation, your anesthesiologist will recommend an anesthetic choice for the case, taking into account your health status and preference and the nature of the surgical procedure.

Sellick Maneuver

The Sellick Maneuver is performed by applying gentle pressure to the anterior neck (in a posterior direction) at the level of the Cricoid Cartilage. The Maneuver is most often used to help align the airway structures during endotracheal intubation. The real value of this procedure is often misunderstood and therefore, is often underutilized. The REAL value of the Sellick Maneuver is to provide a means to prevent gastric insufflation and vomiting during ventilations in an unprotected airway. BLS and ALS medics can direct a member of the resuscitation team to provide this maneuver early and continually until a properly placed endotracheal tube has been inserted. Remember that aspiration pneumonitis has a high mortality rate and proper use of this method can minimize its occurance.

Arthritis Pain Killer

Do you feel pain on your hinge ? Maybe you’ve got arthritis. But don’t worry, because there are many treatment to reduce your pain. Two kind of treatment i.e farmacological or non-farmacological. The farmacological one is NSAID such as aspirin, ketorolac, and sodium diclofenac.

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How safe is anesthesia and what are the risks?

The administration of anesthesia, even to patients with serious health problems, can generally be accomplished safely without major complications and only minor side effects. However, even when carefully and competently administered, serious and potentially life-threatening complications can and do very rarely occur. During the last twenty years improved understanding of how the body reacts to anesthesia and surgery, more sophisticated monitoring devices and better anesthetic agents have dramatically improved anesthetic safety. Anesthetic mortality, as high as 1:15,000 prior to 1980, is now less than 1:200,000 for patients in good health undergoing elective procedures. The risk of anesthetic administration is determined by the patient’s health status, the nature of the surgical procedure and if the care is being provided electively or because of a surgical emergency. If you want to know more about the risk of anesthesia in your case, your anesthesiologist can make the best assessment during your pre-anesthetic evaluation. Anesthetic risk can be reduced by providing complete information about your health to your anesthesiologist and by carefully following our fasting (also called “NPO” or “nothing by mouth”) guidelines and instructions regarding any medication you are taking on a regular basis.