Intubation is a procedure that can help save a life when someone can’t breathe. A doctor uses a laryngoscope to guide an endotracheal tube (ETT) into the mouth and then trachea (windpipe). The tube keeps the airway open so oxygen can get to the lungs. Intubation is usually performed when greater control of breathing is required, during an emergency or before surgery. The tube is then connected to a breathing machine (ventilator, pictured below) which provides assistance with breathing and additional oxygen.
Some common conditions that can lead to intubation include:
- Surgery
- Respiratory (breathing) failure
- Low level of consciousness which can make a person lose control of the airway;
- Risk of aspiration (breathing in food, vomit, blood or saliva);
- Airway obstruction (something blocking the flow of air);
- Cardiac arrest;
- Injury or trauma to the neck, abdomen or chest that affects the airway or breathing.
The Procedure
Intubation is performed by a doctor or team of doctors in the Emergency Department, the operating theatre, the ICU or in an emergency, on the ward. A general anaesthetic is given to the patient before this is done and the patient is monitored throughout. The RPA ICS has clear checklists and guidelines for intubation and we undertake regular training to minimise the risks.
The tube may stay in place for several days to several weeks. If a patient requires airway protection or ventilator support for a long period of time we usually perform a tracheostomy.
The Risks
- The ETT may occasionally damage the trachea, vocal cords, mouth
and teeth; - There may be a reaction to the drugs used for the general anaesthetic;
- There may be reduced oxygen delivery during the procedure;
- The ETT may be accidentally inserted into the oesophagus;
- The ETT may be accidentally dislodged or migrate post insertion.
