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Indications for intubation

Introduction to Indications for Intubation
  • Definition: Intubation refers to the placement of a tube into the trachea to facilitate mechanical ventilation.
  • Objective: To maintain adequate oxygenation and ventilation, protect the airway, and manage intracranial pressure.
Indications for Intubation
  • Respiratory Failure
  • Cardiovascular Instability
  • Airway Protection
  • Severe Metabolic Acidosis
  • Reduced Consciousness
  • Facilitation of Surgery or Procedure
  • Transport
Respiratory Failure
  • Acute Hypoxaemia: PaO2 < 60 mmHg or SaO2 < 90% despite oxygen therapy
  • Hypercapnia: PaCO2 > 45 mmHg with acidosis (pH < 7.35)
  • Respiratory Distress: Use of accessory muscles, severe tachypnoea
Cardiovascular Instability
  • Severe Hypotension
  • Cardiac Arrest
  • Shock States
Airway Protection
  • Severe facial trauma
  • Upper airway obstruction
  • Risk of aspiration
  • Low GCS (see below)
Severe Metabolic Acidosis
  • pH < 7.2
  • Refractory to medical management
Reduced Consciousness
  • Glasgow Coma Scale < 8
  • Drug overdose
  • Other encephalopathic states
Facilitation of Surgery or Procedure
  • General anaesthesia
  • Certain diagnostic procedures requiring airway control
Transport
  • Inter-hospital transfer requiring mechanical ventilation
Contraindications
  • Direct contraindications are rare but may include:
    • Untreated pneumothorax
    • Unstable cervical spine fracture

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