Intubation

Intubation is the best way to protect the airways from aspiration and provide leak-free ventilation. An over-inflation of the stomach is safely avoided and there is the possibility of intratracheal medication (suprarenin, lidocaine, atropine).

The technique of intubation should be mastered by every emergency physician and practiced again and again. Here the different emergency techniques of intubation have to be considered, which as a rule can only be learned by using intubation trainers. In addition to the classical method, the emergency physician should learn the "en face" (frontal) intubation for trapped patients, the blind nasal intubation with e.g. snap breathing and the correct handling of intubations with a guide rod.

For the correct intubation techniques, see the corresponding textbooks on emergency medicine and anaesthesia.

Furthermore, knowledge of anaesthetic induction and anaesthetic guidance is indispensable for patients who are still conscious but require intubation.

Preliminary oxygenation of the patient with mask ventilation is advantageous. According to current ERC recommendations, intubation should take a maximum of 15 seconds to avoid an unnecessarily long no-flow time during resuscitation and is therefore reserved for the expert with sufficient experience in this technique. In the case of defibrillatable arrhythmias, the rapid shock sequence is urgent, intubation is no longer given priority with sufficient oxygenation by mask ventilation. If intubation is performed, care should be taken not to take more than 2 minutes between defibrillation series, whereby the actual intubation procedure, during which no oxygenation takes place, is assumed to take place with a maximum of 15 seconds.