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Back to Chest Procedures
Tracheal
Intubation
Intubation being practiced on a dummy (conventional technique using a
laryngoscope) In medicine, intubation is the placement of a tube into
an external or internal orifice of the body. Although the term can
refer to endoscopic procedures, it is most often used to denote
tracheal intubation. In tracheal intubation, an endotracheal tube is
passed through the nose or mouth, through the larynx, and into the
trachea.
Tracheal intubation is performed in various medical conditions:
- In comatose or intoxicated patients who are unable to protect their
airways. In such patients, the throat muscles may lose their tone so
that the upper airways collapse and air can not pass to the lungs.
Furthermore, protective airway reflexes such as coughing and
swallowing, which serve to protect the lower airways against
aspiration of secretions and foreign bodies, may be absent. With
tracheal intubation, airway patency is restored and the lower airways
can be protected from aspiration.
- In general anesthesia. In anesthetized patients spontaneous
respiration may be decreased or absent due to the effect of
anesthetics, opioids, or muscle relaxants. To enable mechanical
ventilation, an endotracheal tube is often used, although there are
alternative devices such as face masks or laryngeal masks.
- In diagnostic manipulations of the airways such as bronchoscopy.
- In endoscopic operative procedures to the airways such as laser
therapy or stenting of the bronchi.
- In intensive care medicine for patients who require respiratory
support.
- In emergency medicine, particularly for cardiopulmonary resuscitation.
Tracheal intubation can be performed by direct laryngoscopy
(conventional technique), in which a laryngoscope is used to obtain a
view of the glottis. A tube is then inserted under direct observation.
This technique can only be employed if the patient is comatose or
under general anesthesia. An alternative is intubation under local
anesthesia using a flexible endoscope.
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There are various types of tracheal tubes for oral or nasal intubation.
Tubes may be either flexible or preformed and relatively stiff. Most
tubes have an inflatable cuff to seal the lower airways against air
leakage and aspiration of secretions.
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