Artificial airways (breathing tubes)
Endotracheal tube
An endotracheal tube is a long plastic tube used during invasive ventilation. The tube is inserted through the mouth, down through the throat and into the lungs. This process is called intubation. The outer end of the tube is then attached to special tubing, which is connected to a ventilator.
How does it work?
The breathing tube allows gases, including oxygen, to move from the breathing machine to the lungs and then back out again. The breathing tube is held in place with tape or a plastic device. Because the breathing tube passes through the vocal cords, the person will not be able to speak while the endotracheal tube is in position.
How long will it be used for?
Endotracheal tubes are used for only a short time until the person can breath on their own or just need a lower level of breathng support.
The removal of an endotracheal tube is called extubation. If the person needs a breathing tube for a long period, the doctor may want to put a tracheostomy tube in the person’s neck.
Fact sheets in community languages on endotracheal tubes:
العربية
Arabic 中文
Chinese ελληνικά
Greek Italiano
Italian Македонски
Macedonian
Tracheostomy
A tracheostomy tube is a short tube placed in a person's trachea (windpipe) through the neck. This is done under general anaesthesia. It is often called a ‘trache’, pronounced ‘trackie’.
In intensive care, tracheostomy tubes may be used for people who:
- are on a breathing machine for a long time (more than 10 days)
- have problems swallowing correctly so that secretions such as saliva keep getting into their lung, this is known as aspiration
- have serious problems with their windpipe, such as severe infection or damage.
How is it done?
A tracheostomy tube can be inserted in one of two ways:
- in an operating theatre by a surgeon
- in ICU by an intensive care doctor specifically trained in doing the procedure.
The choice and timing of procedure depends on a many things, including the person’s condition and availability of trained staff. The procedure involves making an opening through the neck into the trachea (windpipe), where the tracheostomy tube is inserted and directed down towards the lungs.
The doctors will decide which is the best method, and they will discuss the possible problems when getting consent to do the procedure.
How does it work?
When a person has a tracheostomy tube, air passes through the tube into the patient’s lungs. Secretions from the upper airways (mouth, nose and throat) are stopped from getting into the lungs by a small cuff around the tube. The tracheostomy tube also allows medical staff to remove secretions, such as saliva, from the person’s lungs more easily.
In ICU, a small number of people may need a tracheostomy tube for a short while until their acute illness is over.
A tracheostomy can make it easier for the person to breathe. It also can make it easier for nurses to clean the person’s mouth. This is important because if a person is unconscious, they might have difficulty keeping their airway clear and swallowing properly.
Tracheostomy tubes stop air from passing through the voice box. This means the person is unable to speak. However, in these situations, a special trache tube might be used that can allow the person to speak.
Once the reasons for having the tracheostomy tube have resolved, the person will go through a weaning process and the tube will be removed. This weaning process is supervised by the ICU team.
Some people are discharged from ICU with a tracheostomy tube still in. When this happens, there is a special team of doctors, nurses, physiotherapists and speech pathologists who help the person – this may take from days to months.
Once the tracheostomy tube is removed, the hole will close over and the person will be able to breathe normally.