Intubation
The insertion of a long breathing tube or artificial airway (endotracheal tube) into the windpipe through the mouth is called intubation. At times, the tube may be inserted through the nose instead of the mouth.
Purpose
Intubation is needed when someone is unable to breath for themselves or is having difficulties in breathing.
The tube will usually be attached to a breathing machine (ventilator). This equipment will take over some or all of the work of breathing until the person is able to breathe on their own.
What is done?
Intubation is generally a planned procedure and is done by a team of trained medical staff, normally headed by a doctor. This team works together to make sure that the procedure is done in a safe and timely way. Intubation procedures are similar across hospitals, where most people are given general anaesthetic so they are asleep during the procedure.
During the procedure, the person is laid flat and remains connected to a bedside monitor so the team can keep checking vital functions (heart rate, blood pressure, etc.). The person is given anaesthetic medicines through an intravenous cannula to put them to sleep. The doctor uses a laryngoscope to open up the mouth and see down the throat, and then passes the endotracheal tube through the mouth and into the trachea (windpipe).
The endotracheal tube has a cuff, or balloon, around its middle. This cuff is inflated to create a seal around the tube within the trachea. This stops the mouth secretions going into the lungs.
The medical team makes sure that the endotracheal tube is in the correct position. A chest x-ray is done to confirm this. Once checked, the tube is kept in place by using either white cotton tape, adhesive tape or a plastic device. The other end of the tube will then be attached to a ventilator.
What happens next?
Once the ICU team is sure the endotracheal tube is in the right place, a specific ventilation plan will be created to give the person the right level of breathing support. This plan will include the types of sedation used (to cause sleepiness) so that the person is able to tolerate the tube.
The person won’t be able to talk because the endotracheal tube stops air from moving through the voice box. But most will be able to respond in some way, so talking to them in a quiet way is a good idea. If the person is awake, the nurse will explain what is going on and reassure them.
Rarely, a person will be intubated because something is blocking their airways, such as swelling or infection. This person may not need a breathing machine (ventilator). Once the person’s condition improves, the tube will be removed (extubation).
Are there any problems?
The most common problems happen when the breathing tube is placed incorrectly. This will be become quickly obvious when checking the vital signs, which is done by the doctor immediately after intubation.