What is e-mac intubation?

During intubation, the anesthetist places the tube between the vocal folds and then pushes it into the trachea. This can only be done safely if the glottis is clearly visible. Therefore, a laryngoscope is used for insertion, with which the tongue can be pushed aside and the lower jaw raised.

However, even then it is still possible that the glottis is not visible, e.g. in obese patients or thoracic deformities. A C-Mac videolaryngoscope can help here. It has a built-in camera and monitor, which can be used to see the glottis and safely insert the tube even in difficult patients. In addition to the intubation under sight, the patient is monitored to rule out that the tube has accidentally entered the esophagus. A capnometer is also connected to measure the CO2 that flows through the tube during exhalation.

What does the intubation set include?

The intubation set consists of several parts and is mainly used in the rescue service in addition to intubation before an operation in hospital. It contains: Endotracheal tubes in different sizes; a laryngoscope including a fluoroscopic spatula; an insertion stylet, which is inserted into the tube for intubation to make it more rigid and thus facilitate intubation; after successful insertion of the tube, the stylet is removed again; a blocking syringe, with which the tube is blocked to prevent it from being torn out easily; blocking clamp; lubricant (e.g. (e.g. gel) to make it easier to insert the tube; a fastening strap to prevent the tube from slipping and a Guedel tube.The Guedel tube is used to fix the tongue of unconscious patients so that it cannot be swallowed and thus helps with mask ventilation. Intubation should always be performed by a physician.

What drugs are used for intubation?

Three different types of medication are used intravenously for intubation: a hypnotic (anesthetic), an opioid (painkiller) and a muscle relaxant. First the opioid, e.g. fentanyl, is administered. It suppresses the pain stimulus and has a mild sedative effect on the patient.

Then the hypnotic, e.g. Propofol, is administered. This leads to a loss of consciousness in the patient. Finally, the muscle relaxant is administered, e.g. Rocuronium. This leads to paralysis of the skeletal muscles and the patient must now be ventilated and intubated. During the operation the anaesthesia is maintained by anaesthetic gases or intravenous drugs.