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Procedure Note: Intubation
Intubation Time (mandatory: please be as accurate as possible)
Now
Timeout
emergent
protocol/checklist
Indication
airway protection
resp failure
Consent
verbal
emergent
patient
family
Assessment
last oral intake noted
Mallampati 1
Mallampati 2
Mallampati 3
Mallampati 4
prior anesthesia history
Preparation
position/monitor
equipment
Medications
ketamine
etomidate
propofol (pre)
succinylcholine
rocuronium
propofol (post)
fentanyl (post)
Technique
video laryngoscopy
direct laryngoscopy
bougie
7.0 Fr ETT
7.5 Fr ETT
8.0 Fr ETT
Confirmation of Tube
ETCO2 waveform
direct visualization
color change
breath sounds
chest Xray
Complications
none, O2 over 90%, first pass
hypoxia, less than 90%
hypotension, SBP less than 90
no hypotension
multiple attempts
Provider
Copy to Clipboard
Clear
Macros
Video 7.5
Note
: BlueWater strongly encourages the use of waveform capnography to confirm tube placement.