What is Retromolar intubation?

Retromolar intubation has a unique place amongst the methods of securing airway in panfacial trauma. It is an alternative to orotracheal, nasotracheal and submento-tracheal intubations. It is non-invasive technique of securing airway in patients with panfacial trauma.

What are the steps to intubate a patient?

Applying firm, steady upward pressure at a 45-degree angle, the curved laryngoscope is used to lift the epiglottis and expose the vocal cords. Once the glottis is visualized, the operator will ask the respiratory assistant to place the endotracheal tube with the malleable stylet on the operator’s right hand.

How is tracheal intubation done?

Endotracheal intubation is a procedure by which a tube is inserted through the mouth down into the trachea (the large airway from the mouth to the lungs). Before surgery, this is often done under deep sedation. In emergency situations, the patient is often unconscious at the time of this procedure.

What was the first way to create an endo tracheal intubation?

Macewen in 1878 reported the first elective endotracheal intubation for anesthesia. He isolated the trachea by packing the hypopharynx, from leaking of blood and debris.

What is submental intubation?

[4] Submental intubation technique consists of passing the tube through the anterior floor of mouth, allowing free intraoperative access to oral cavity and nasal pyramid without endangering patients with skull base trauma.

Are intubated patients conscious?

Intubation Procedure Prior to intubation, the patient is typically sedated or not conscious due to illness or injury, which allows the mouth and airway to relax. The patient is typically flat on their back and the person inserting the tube is standing at the head of the bed, looking at the patient’s feet.

What does tracheotomy mean?

Tracheostomy (tray-key-OS-tuh-me) is a hole that surgeons make through the front of the neck and into the windpipe (trachea). A tracheostomy tube is placed into the hole to keep it open for breathing. The term for the surgical procedure to create this opening is tracheotomy.

Who invented the tracheal tube?

In 1543, Vesalius reported intubating an animal, the first documented case of a tracheal intubation [1]. Fast-forward to 1778 when Dr. Charles Kite is credited with developing the first endotracheal tube.

Where is the submental area?

The submental space is located below the chin and is bound above by the skin and the chin (mentalis) muscles, laterally by the anterior bellies of the digastric muscles, deeply by the mylohyoid muscle, and superiorly by the deep cervical fascia, the platysma muscle, the superficial fascia, and the skin.

How is retromolar intubation used in panfacial trauma?

Retromolar intubation is a non‐invasive technique and avoids both submento‐tracheal intubation and tracheostomy in the majority of patients. In 15 patients with panfacial trauma, where orotracheal intubation was not feasible and nasotracheal intubation contra‐indicated, retromolar intubation was attempted to avoid tracheostomy.

What do I wear to an endotracheal intubation procedure?

I wore a surgical cap, mask with protective eyewear, gown and gloves throughout the procedure. The patient was placed on a cardiac monitor including continuous pulse oximetry.

How is an endotracheal tube inserted in a paralyzed patient?

Once the patient was adequately sedated and paralyzed, a Mac 4 laryngoscope was used to directly visualize the cords. Using this direct visualization, a 7.5 endotracheal tube was then passed easily through the cords. This tube was inserted to 21 cm at the lip.

How are breath sounds heard during endotracheal intubation?

Breath sounds were heard in both lung fields equally. The endotracheal tube was placed at 23 cm, measured at the teeth. was present for the entire procedure. A chest x-ray was ordered to assess for pneumothorax and verify endotrachealtube placement.