Endotracheal Intubation | Pulmonary & Critical Care

Intubation

What is an intubation?Intubation is a general term referring to the placement of a tube into a patient’s body. The most common use of this term in the ICU refers to placing a breathing tube into a patient’s airway (endotracheal intubation).

Why is endotracheal intubation needed?
Endotracheal intubation is necessary when patients can no longer cough and clear secretions or breathe on their own.

Does endotracheal intubation hurt?
If the breathing tube is placed through the nose, the patient will feel some discomfort. The patient will receive sedation and pain medications for this. If the breathing tube is placed through the mouth, the patient will receive anesthesia. After the tube is in place most patients have temporary difficulties with gagging that slowly lessens with time. Patients can not speak or eat while the breathing tube is in place.

How is endotracheal intubation done?
Patients needing endotracheal intubation usually have a serious condition preventing them from breathing on their own. An endotracheal tube (breathing tube) can be inserted through the mouth or through the nose then advanced into the airway. Some patients do not require much sedation when the endotracheal tube is inserted through the nose. The breathing tube is slowly advanced into the nose passage and then slips into the patient’s airway. Patients always require sedation when the endotracheal tube is inserted through the mouth. The person placing the breathing tube uses a small device called a laryngoscope to move the patient’s tongue out of the way to see the airway. The endotracheal tube is then inserted while looking directly at the airway.

Are there any potential complications associated with use of an endotracheal tube?
Yes. The mouth, teeth, and upper airway can be damaged while the tube is being placed. After the tube is in place the vocal cords can be injured. The presence of the endotracheal tube places the patient at risk for pneumonia.

An endotracheal (ET) tube has been inserted into this patient’s airway through the mouth by a procedure called endotracheal intubation. The tube in the nose is called a nasogastric (NG) tube.

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