Intubation Lab

So I just finished a really cool after school lab with the anesthesia interest group. We were down in the sim lab and learned how to intubate. A third year resident showed us how to use the bag valve mask and then how to intubate. We split off into groups and practiced intubating on dummies, then on each other. No, I'm just kidding. We were only practicing on dummies. The laryngoscope is basically an "L" shaped instrument with a light pointing down the short part of the 'L'. There are two types, the Miller and the Macintosh, which vary in the degree of curvature of the blade (short part of the 'L'). We were using Macs since that's what works with the dummies. So, with a Mac blade here's how you intubate: Holding the scope in your left hand, you sweep the patient's tongue out of the way, inserting from the right and sweeping left. You then pull the scope upwards and away, at about a 45º. The end of the blade should be in the valecula. This should expose the vocal cords, which are your target. Once you can see the cords, you take your endotracheal tube which has a stylet in it for rigity, and attempt to place the tube between the cords and into the trachea. The tube should be positioned about 7cm above the carina (where the trachea branches into the two main bronchi). Then you inflate the balloon at the end with about 10cc of air and withdraw the stylet. The patient is then ready for ventilation! It was a lot of fun to actually do something clinical with my hands, as opposed to studying the side effects of chemotherapy drugs, which is what I'll get to do tonight.