What Is Intubation and When Is It Necessary?

With this year's spread of COVID-19, we've all heard a lot about respiratory health and emergency medicine from respirators and ventilators to intubation. But, some of these terms are pretty hard to understand if you aren't a doctor.

If you're feeling overwhelmed, relax. You aren't alone. In this article, we'll teach you all that you need to know about one of these complex concepts - intubation.

Intubation is an emergency medical procedure performed when a patient can't breathe on their own. In this article, we'll help you understand how the procedure works, the methods used by doctors, and the potential risks associated.

Keep reading for all the information.

What Is Intubation?

Intubation is a common medical procedure that involves inserting a tube, called an endotracheal tube (ET), through the mouth and into the airway. This is typically done so that a patient can be placed on a ventilator, which inflates the lungs to deliver air to the patient.

A patient might be intubated to assist with breathing during general anesthesia or other heavy sedation; or if they are severely ill and unable to breathe on their own.

Most patients are extubated, or have their breathing tube removed, immediately after surgery or as soon as their illness has passed. But, if the patient is still struggling to breathe on their own, they may rely on the ventilator for a longer period.

Intubation is also performed in cases of respiratory failure. This medical emergency may be caused by injury to the lungs, severe pneumonia or other respiratory illness, and breathing problems like COPD.

Simply put, any time a patient cannot take in enough oxygen on their own, the use of intubation and a ventilator may be necessary.

While this procedure might sound scary, it's actually a pretty common practice. And, most patients don't need to be intubated for long. In the next section, we'll explain the two common methods used to perform intubation, to help you understand the process in depth.

Methods

Most intubations are performed via a patient's mouth. But in some cases, like during throat surgery, a nasal application is required.

Before intubation, the patient is sedated and placed flat on their back, allowing the mouth and airway to relax. Then, the mouth is gently opened. A lit instrument is used to keep the tongue out of the way, and to light up the throat.

Once properly positioned, the endotracheal tube is gently guided into the throat and down through the airway.

A small balloon around the tube is used to hold it in place, and to keep air from escaping back up through the trachea. And, the tube is tied or taped in place at the mouth to prevent movement.

Doctors will then check for successful placement by listening to the lungs with a stethoscope, and if results are unclear, they will be verified with a chest x-ray. A device that measures carbon dioxide is also used to monitor the patient for proper placement and breathing.

Nasal intubation involves a similar procedure. The primary difference is that with this method, a different type of tube called a nasotracheal tube (NT) is used.

This smaller tube goes up the nose, down the throat, and into the airway. In most cases, nasal intubation is performed when doctors need to keep the mouth empty in order for surgery to be performed.

This type of intubation is less common, as it is more difficult to perform. And, it is seldom used during routine surgery or respiratory failure.

Risks

While intubation is a generally safe procedure, it does come with a few risks. This is especially true if the patient must remain on the ventilator for an extended time. Some common intubation complications include:

• Minor injuries to the teeth, mouth, and tongue
• Minor injuries to the larynx or trachea
• Accidental intubation of the esophagus (food passageway)
• Aspiration of vomit, saliva or other fluids
• Pneumonia, often the result of aspiration

Even when a procedure goes perfectly there are a few intubation side effects to watch out for. These include:

• Minor bleeding
• Sore throat
• Hoarseness

In some extreme situations, patients can experience more serious complications. These include an inability to be weaned off the ventilator, eventually requiring a tracheostomy; and erosion of soft tissue in the esophagus and mouth from prolonged intubation.

No matter what medical situation is being addressed via intubation, be sure to discuss all the potential risks before moving forward with a procedure.

You should also keep in mind that intubation and ventilator use put stress on the body.

You'll want to put together a plan for recovery with your doctor, and be sure to include the hospital to home transition. That way, you'll be totally prepared when the time comes! This plan might include purchasing medical supplies or even hiring a home healthcare worker.

Now You Know

Now that you're familiar with the basics of intubation, you're prepared to make medical decisions with authority.

Keep in mind, the need to be intubated is common with general anesthesia and serious illness. And, while it sounds scary to imagine being placed on a ventilator, it is a routine part of emergency medicine and a standard surgical practice.

If you have concerns about yourself or a loved one being intubated and placed on a ventilator, be sure to discuss them with the surgeon or anesthesiologist on site.

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