5 Ws and 1 H of Intubation

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Who?

Any patient who is at risk of decompensating. Generally, the patient is usually1:
1. SpO2 < 90% or less
2. RR <10 or >30
3. Expected condition deterioration

What?

Intubation is the practice of inserting an endotracheal tube into the patient’s mouth and into the trachea so that a ventilator can be attached.

An endotracheal tube is simply a tube that sits in the trachea and is held in position with ties or an anchor, and a balloon.

By bigomar2 – Self-photographed, CC BY-SA 3.0, Link

Where?

Any critical care area or in any emergency situation.

When?

It may be planned or it may be emergent. Be prepared for it to happen anytime.

Why?

Patients with COVID-19 have severe oxygenation problems, with or without terrible ventilation problems, requiring mechanical ventilator support1.

The ventilator can help the lung improve gas exchange by increasing the amount of oxygen at the alveoli and increasing the effectiveness of breaths taken to blow off  carbon dioxide.

References

  1. Lingzhong Meng, Haibo Qiu, Li Wan, Yuhang Ai, Zhanggang Xue, Qulian Guo, Ranjit Deshpande, Lina Zhang, Jie Meng, Chuanyao Tong, Hong Liu, Lize Xiong; Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan’s Experience. Anesthesiology 2020;No Pagination Specified. doi: https://doi.org/10.1097/ALN.0000000000003296.

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