(5) Laryngoscope. This device is used to see the larynx. A laryngoscope
has two different types of blades: the Miller blade which is straight and the MacIntosh
blade which is curved. The component parts are:
(a) Handle ("L" type or right angle is the most commonly used handle).
Handles come in small, medium, and large sizes.
(b)
Flashlight and penlight batteries.
(c)
A blade that snaps onto the handle.
b. Complications.
(1) In the process of inserting the tube, teeth may be broken or chipped;
nasal, oral, and pharyngeal soft tissue may be damaged; or the vocal cord may be
damaged.
(2) The tube may be accidentally pushed into the esophagus causing a total
airway obstruction and finally death, if the situation is not corrected.
(3) If the tube is pushed into the bronchus (either of the two main branches
of the trachea), the casualty may suffer pneumothorax, bronchospasm, laryngospasm,
hypoxemia, cardiac arrhythmias, or irritation of the carina with subsequent coughing.
(4)
Endotracheal tube obstruction. Foreign bodies, mucous, etc. may block
the tube.
(5) The trachea or vocal cords may become ulcerated because of increased
pressure by the ET cuff.
(6) After the endotracheal tube is removed, the casualty may experience
laryngospasm (spasmodic closure of the larynx), infection, and hoarseness (sore
throat).
2-11. PROCEDURAL STEPS FOR INTUBATING--OROTRACHEAL TUBE
Complete the following steps to intubate correctly:
a. Gather the equipment and check it.
(1) Tube. Select the type (vinyl, rubber, or plastic) and the size of the tube.
Use anatomy considerations and measurements in your selection. (The inflatable cuff
comes with the tube.)
(2)
Stylet.
MD0569
2-10