Intubation has been successfully used in the practice of resuscitation anesthetists for over a century, helping to save the lives of millions of people every year. This procedure is one of the most common operations performed in intensive care daily. However, the insertion of a tube into a patient’s trachea might have adverse effects (van Esch, Stegeman and Smit, 2017). The diagnostic methods for preventing intubation-related complications are laryngoscopy, bronchoscopy and an x-ray examination of the respiratory tract. Moreover, to predict deteriorations, shock index can be measured before inserting an endotracheal tube (Althunayyan, 2019). The purpose of this paper is to discuss how intubation-related problems can be prevented using shock index measurement.
Complications of tracheal intubation are pathological conditions that occur when an endotracheal tube is inserted into the airways or after the procedure. Symptoms of such complications depend on the type of adverse effects (van Esch, Stegeman and Smit, 2017). They might include diffuse cyanosis, barking cough, hemoptysis and other signs (van Esch, Stegeman and Smit, 2017). After the removal of the equipment, the patient might have pharyngodynia. However, the most serious problems that can occur during or after tracheal intubation are hypotension and cardiac arrests (Trivedi et al., 2015). They might worsen the patient’s condition and even increase the risk of fatal outcome. In order to prevent such consequences, doctors can take down patients’ shock indexes.
The ways to predict if a person is going to have a heart arrest or hypotension with the use of shock index are described in several articles. As the main source of this paper, I have chosen a work on shock index. It is “Evaluation of Preintubation Shock Index and Modified Shock Index as Predictors of Postintubation Hypotension and Other Short-Term Outcomes” by S. Triverdi et al. The work is concentrated on the indicator of shock index that might be regarded as a warning sign and provide readers with concise information on the topic (Trivedi, S. et al, 2015). The researchers note that if the preintubation shock index equals to 0.90 or is higher, postintubation hypotension is likely to develop (Trivedi, S. et al, 2015). The resource of the article is The National Center for Biotechnology Information.
I have selected the source because it is useful for extending my knowledge and is closely connected with my acute practice as a nurse. In my former workplace, I saw several patients who had cardiac arrests and hypotension after intubations. The situations were managed with the help of other specialists. In light of the sources, in the same cases, I would measure shock index first and act accordingly.
To sum up, it is significant to press the point that before conducting endotracheal intubation, a doctor should always measure his or her patient’s shock index. It can help to predict the development of complications and manage the situation. In addition to the source described above, there are two other papers that might be helpful for a practicing nurse in his or her work. The first one is “Shock Index as a Predictor of Post-Intubation Hypotension and Cardiac Arrest; a Review of the Current Evidence” by S.M. Althunayyan. The other work is called “Comparison of Laryngeal Mask Airway vs Tracheal Intubation: a Systematic Review on Airway Complications” and written by B.F.van Esch, I. Stegeman and A.L. Smit.
Reference List
- Althunayyan, S.M. (2019) ‘Shock index as a predictor of post-intubation hypotension and cardiac arrest; a review of the current evidence’, Bulletin of Emergency & Trauma, 7(1), p. 21.
- Trivedi, S. et al. Demirci, O., Arteaga, G., Kashyap, R. and Smischney, N.J. (2015) ‘Evaluation of preintubation shock index and modified shock index as predictors of postintubation hypotension and other short-term outcomes’, Journal of Critical Care, 30(4), pp. 861-e1.
- van Esch, B. F., Stegeman, I. and Smit, A. L. (2017) ‘Comparison of laryngeal mask airway vs tracheal intubation: a systematic review on airway complications’, Journal of Clinical Anesthesia, 36, pp. 142-150.