Technique
•Prior to attempting the insertion of an ETT and as indicated by clinical condition, one should ventilate the infant with bag and mask using 80-100% oxygen. If unable to insert the ETT within 30 seconds, ventilate the infant again for 30-60 seconds before reattempting intubation.
•Infant's head should be slightly extended (in the sniffing position) with the body aligned straight.
•The laryngoscope is held with the left hand. Pushing down gently on the larynx with the fifth finger of the left hand (or having an assistant do it) to provide slight cricoid pressure may help to visualize the vocal cords. Avoid extreme tension or tilt of the laryngoscope.
•The ETT is held in the right hand and inserted between the vocal cords so that the tip is 1-2 cm below the vocal cords.
•Ensure endotracheal position by the use of a CO2 detector- this has become a standard of care. The detector should change color (purple to yellow) by 5-6 breaths.
•Check tube position by auscultation of the chest (and abdomen) to ensure equal aeration of both lungs and observation of chest movement with positive pressure inflation.