Overview & Description
Endotracheal intubation is the insertion of a tube through the nose or mouth into the windpipe, or trachea.
Who is a candidate for the procedure?
Intubation may be done to:
keep the airway open, such as while cardiopulmonary resuscitation (CPR) is being performed
give a person general anesthesia or oxygen
Intubation is needed:
when a person does not have enough oxygen in their blood
when a person cannot breathe properly or has too much carbon dioxide in their blood. Carbon dioxide is normally breathed out when a person exhales if the lungs are working properly. When too much of it builds up, it is toxic to the body.
when secretions must be removed from the lungs or controlled. This may be necessary, for example, when a person has severe lung disease.
to protect the airway in a person whose gag reflex is depressed, which makes lung infections more likely. This might be needed after a head injury, for example, or a neurological injury that affects the respiratory system.
How is the procedure performed?
Before the procedure:
the person will be given oxygen through a special face mask
he or she will be sedated, if possible. Medication that relaxes the person may be given along with another medication that paralyzes the muscles in the body for a short period of time.
a special suction device will be available to remove secretions from the mouth
The intubation may be done through the mouth or nose, using one of the following methods:
A tube is inserted through the mouth into the trachea. A lighted tool called a laryngoscope is used to examine the throat and make sure the tube goes in properly. The neck is positioned with the head back to make this as easy as possible to see.
A tube is inserted through the nose and into the trachea. This is done blindly without the use of a laryngoscope to see the windpipe opening. Because this technique does not require special positioning of the neck, it is useful when the patient has a neck injury.
Preparation & Expectations
What happens right after the procedure?
Once the tube has been inserted:
it is attached to a bag that can be squeezed to deliver breaths to the person
its placement will be checked by listening for airflow sounds over the lungs
a chest X-ray will be taken to confirm that the tube is in the right place
an arterial blood gas test may be done to check for proper levels of oxygen and carbon dioxide
the person may be sedated
A person who has been intubated cannot talk.
Home Care and Complications
What happens later at home?
A person must stay in the hospital until the tube is removed. Once it has been removed, he or she may have a sore throat due to irritation from the tube.
What are the potential complications after the procedure?
Intubation may cause complications. Some possibilities are:
esophageal intubation, which occurs when a tube is put into the esophagus or food tube by mistake, instead of into the trachea. To keep this from happening, the healthcare provider who has done the intubation listens with a stethoscope over the stomach while giving oxygen to the person through the tube. If airflow sounds are heard over the stomach or the stomach swells up, the tube is in the esophagus. It must be removed and placed properly.
swelling at the back of the throat
vocal cord injury
damage to the trachea, including a hole
damage to teeth
lung infection such as pneumonia
spasm of the muscles of the windpipe, which may cause pain and difficulty breathing
Article type: xmedgeneral