References

Al-Shaikh B, Stacey S. Tracheal and tracheostomy tubes and airways.: Elsevier Ltd; 2013

Alderson B, Senior JM, Dugdale AHA. Tracheal necrosis following tracheal intubation in a dog. J Small Anim Pract. 2006; 47:(12)754-756 https://doi.org/10.1111/j.1748-5827.2006.00161.x

Recommended practices for cleaning, handling and processing anesthesia equipment. AORN J. 2005; 81:(4)856-870 https://doi.org/10.1016/S0001-2092(06)603657

Aspinall V, Cappello M. The Respiratory system. Structure and function, veterinary anatomy and physiology. Introduction to animal and veterinary anatomy and physiology, CABI, Oxford. 2020;

AVTAA. Academy of Veterinary Technicians in Anesthesia & Analgesia - AVTAA / Application Forms. 2022. https://www.avtaa-vts.org/application-forms.pml (accessed 3 January 2022)

Burbidge HM. A review of laryngeal paralysis in dogs. Br Vet J. 1995; 151:(1)71-82 https://doi.org/10.1016/S0007-1935(05)80066-1

Fletcher DJ, Boller M, Brainard BM RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 7: Clinical guidelines. J Vet Emerg Crit Care. 2012; 22:S102-31 https://doi.org/10.1111/j.1476-4431.2012.00757.x

Haider G, Lorinson K, Lorinson D, Auer U. Development of a clinical tool to aid endotracheal tube size selection in dogs. Vet Rec. 2020; 186:(5) https://doi.org/10.1136/vr.105065

Hughes L. Breathing systems and ancillary equipment. In: Duke-Novakovski T, de Vries M, Seymour C (eds). Glouicester: British Small Animal Veterinary Association; 2016

Dental Limited. IM3 Anaesthesia Tube Ties. 2022. https://www.im3vet.eu/im3-anaesthesia-tube-ties (accessed 3 January 2022)

Langton SD, Blevins MB. The time required to achieve endotracheal intubation in dogs: a comparison of veterinary students and qualified veterinary surgeons. Vet Anaesth Analg. 2021; 48:(5)745-748 https://doi.org/10.1016/j.vaa.2021.05.002

Mitchell SL, McCarthy R, Rudloff E, Pernell RT. Tracheal rupture associated with intubation in cats: 20 cases (1996–1998). J Am Vet Med Assoc. 2000; 216:(10)1592-1595 https://doi.org/10.2460/javma.2000.216.1592

Mosley CA. Anaesthesia equipment, The Fifth Edition of Lumb and Jones. In: Grimm KA, Lamont LA, Tranquilli WJ, Greene SA, Robertson SA (eds). : John Wiley & Sons, Incorporated; 2015

Panti A, Cafrita IC, Clark L. Effect of intravenous lidocaine on cough response to endotracheal intubation in propofol-anaesthetized dogs. Vet Anaesth Analg. 2016; 43:(4)405-411 https://doi.org/10.1111/vaa.12332

Prasse SA, Schrack J, Wenger S, Mosing M. Clinical evaluation of the v-gel supraglottic airway device in comparison with a classical laryngeal mask and endotracheal intubation in cats during spontaneous and controlled mechanical ventilation. Vet Anaesth Analg. 2016; 43:(1)55-62 https://doi.org/10.1111/vaa.12261

Anaesthesiology

Endotracheal intubation of the dog and cat

02 May 2022
Practical
13 mins read
02 May 2022
Volume 13 · Issue 4
Figure 1. Diagram of anatomical features associated with endotracheal intubation.
Figure 1. Diagram of anatomical features associated with endotracheal intubation.

Abstract

Endotracheal intubation is performed for general anaesthesia, critical care, and emergency situations. As the veterinary surgeon often performs this procedure, it may be under-developed, or minimally practiced by veterinary nurses (VNs) despite being legal to perform in several countries. As an emergency skill, and as the role of VNs grows, this article aims to act as a resource for VNs wanting to learn to perform endotracheal intubation correctly. This article will only review the purpose of endotracheal intubation, the relevant anatomy and physiology, equipment, techniques, and troubleshooting. It will not offer a detailed comparison of endotracheal intubation versus laryngeal mask airway, nor will it discuss the technique for endotracheal tube cuff inflation as the full scope of published data, experiences and opinions could not be given due justice: moreover, this is an area of the skill VNs are already familiar with. Maintenance of the in-situ tube and extubation are also excluded and all of these subjects warrant further discussion in a separate article.

Veterinary nurses (VNs) hold a wide and varied skillset in order to provide the best possible care to their patients. VNs regularly assist with anaesthesia and have many skills in this area, including assisting with the induction of anaesthesia by incremental intravenous agents. Intubation of the trachea is routinely performed immediately after this and because of the positioning of the veterinary surgeon (VS), the VS often performs this skill. For this reason, the skill of endotracheal intubation can be under-developed, or minimally practiced by VNs even though they are legally allowed to perform this skill in the UK. Endotracheal intubation may also need to be performed in an emergency situation, where a VS is not present, as it is a key step of providing cardiopulmonary resuscitation (CPR) and so VNs should be confident to perform this skill (Fletcher et al, 2012). As the advanced VN role develops in the UK, it may be common for VNs to be more involved with anaesthesia induction and the skill of endotracheal intubation may be more regularly required. In some states in the USA veterinary technicians already have a greater role in anaesthesia induction: indeed, nurses must master the skill of endotracheal intubation in order to become credentialed as a Veterinary Technician Specialist (VTS) in Anaesthesia and Analgesia (AVTAA, 2022).

Register now to continue reading

Thank you for visiting The Veterinary Nurse and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.

Register
Or continue by

Signing in with your registered email address

intubation
trachea
endotracheal tube
laryngoscope
clinical skills