What Is Endotracheal Intubation?

Endotracheal intubation is when a tube is inserted through the mouth down into the trachea (the large airway from the mouth to the lungs) to administer mechanical ventilation. Before surgery, we often do it under deep sedation. In emergencies, the patient is often unconscious at the time of this procedure.

What kind of intubation tube do we use?

The tube used today is usually a flexible plastic tube. We call it an Endotracheal Tube because it is slipped within the trachea.

How is the tube inserted into the trachea in endotracheal intubation?

The doctor often inserts the tube with the help of a laryngoscope, an instrument that permits the doctor to see the upper portion of the trachea, just below the vocal cords.

We use a laryngoscope to hold the tongue aside during the procedure while inserting the tube into the trachea. The head must be positioned appropriately to allow for proper visualization.

Pressure is often applied to the thyroid cartilage (Adam's apple) to help with visualization and prevent possible aspiration of stomach contents.

What is the purpose of endotracheal intubation?

The endotracheal tube serves as an open passage through the upper airway.

The purpose of endotracheal intubation is to permit air to pass freely to and from the lungs to ventilate the lungs.

Endotracheal tubes can be connected to ventilator machines to provide artificial respiration.

It can help when a patient is unconscious and by maintaining a patent airway, especially during surgery.

We often use it when patients are critically ill and cannot maintain adequate respiratory function to meet their needs.

The endotracheal tube facilitates the use of a mechanical ventilator in these critical situations.

Is endotracheal intubation used for COVID-19 coronavirus patients?

Endotracheal intubation has been approved for providing breathing support to COVID-19 coronavirus disease patients.

Non-invasive mechanical ventilation like CPAP (continuous positive airway pressure) machines used for sleep apnea are not suitable for COVID-19 patients, according to clinical guidelines from the American Society of Anesthesiologists. In some cases, CPAP masks or nasal pillows may provide adequate oxygen. Still, current devices aerosolize virus particles in the patient's breath and spread them around wherever the patient is housed, potentially infecting more people in the area.

Endotracheal intubation and ventilation support a COVID-19 patient's breathing so the body can survive as the immune system fights the virus. It means a better chance of fighting off the virus, but ventilators can't cure COVID-19.

What are the complications of endotracheal intubation?

If the doctor places the tube inadvertently in the esophagus (right behind the trachea), the patient will not breathe adequately.

Brain damage, cardiac arrest, and death can occur. Aspiration of stomach contents can result in pneumonia and ARDS.

Placement of the tube too deep can result in only one lung being ventilated and can result in a pneumothorax as well as inadequate ventilation.

During endotracheal tube placement, damage can also occur to the teeth, the soft tissues in the back of the throat, as well as the vocal cords.

A physician with experience in intubation should perform this procedure. In the vast majority of cases of intubation, no significant complications occur.