Endotracheal intubation is a medical procedure to insert breathing apparatus in the form of tube into the windpipe (trachea) through the mouth or nose. Intubation aimso that the patient can breathe while anesthetic procedures (anaesthesia), during operation, or in patients with severe conditions who may experience difficulty in breathing.
Endotracheal intubation is generally performed on patients who are unconscious, comatose, or unable to breathe on their own. Intubation can help keep the patient's airway open and prevent the patient from experiencing oxygen deprivation due to respiratory failure.
Intubation Procedure
The intubation procedure is one of the most important life-saving techniques of artificial respiration. When the intubation procedure will be carried out the doctor will give drugs, such as general anesthesia and muscle relaxants, to facilitate intubation. The patient is then laid down, then the doctor will open the patient's mouth and insert an instrument called a laryngoscope to open the airway and see the vocal cords.
Once the vocal cords are visible and open, the doctor will insert a flexible plastic tube, called an endotracheal tube, from the mouth into the windpipe. The size of the tube is adjusted according to the age and size of the patient's throat. In the intubation process, if there is difficulty inserting the tube through the mouth, the doctor will insert a breathing apparatus in the form of a special tube through the nose into the respiratory tract.
Next, the endotracheal tube will be connected to a temporary breathing pump bag or to a breathing apparatus (ventilator), which will push oxygen into the patient's lungs.
After the intubation procedure, the doctor will evaluate whether the breathing tube is properly attached, by observing the movement of the breath and listening for breath sounds in both lungs using a stethoscope. If needed, the doctor can perform an X-ray examination to make sure the endotracheal tube is properly inserted.
Purpose of Procedure Intubation Endotracheal
There are various purposes of doing intubation, namely:
- Removes obstructions in the respiratory tract.
- Opens the respiratory tract so that the doctor can deliver oxygen or drugs into the patient's body.
- Assist breathing in people with diseases or conditions that can threaten breathing, such as status epilepticus, status asthmaticus (emergency in asthma that does not improve with treatment), anaphylaxis, severe pneumonia, COPD, pulmonary swelling, serious injuries to the face and neck, pulmonary embolism, heart failure cardiac arrest, severe head injury, or in shock patients.
- Makes it easier for doctors to see the upper respiratory tract.
- Prevents the entry of food, stomach acid, saliva, and other foreign objects into the lungs, when the patient is unconscious.
- Provide respiratory support for patients undergoing surgery under general anaesthesia.
However, in some cases, endotracheal intubation cannot be performed. Conditions that prevent a person from being intubated include being unable to open the mouth, severe neck injury, total airway obstruction, failed intubation after repeated attempts, and deformity of the airway.
Possible Risks of Endotracheal Intubation Procedure
Although it is one of the most important actions to take to provide respiratory support to patients, endotracheal intubation also has risks, namely:
- Bleeding and injury to the windpipe, mouth, tongue, teeth, and vocal cords.
- The breathing tube does not enter the throat, but into the esophagus. As a result, the breathing assistance provided cannot reach the lungs.
- Accumulation of fluid in tissues and organs.
- Aspiration pneumonia.
- Sore throat.
- The voice became hoarse.
- Erosion or erosion of soft tissue in the airways due to long-term intubation.
- Dependence of the patient on the ventilator, so that the patient cannot breathe normally and requires a tracheostomy.
- The occurrence of a tear in the chest cavity that causes the lungs to not function.
- Allergic reaction to the anesthetic used.
Things to Pay Attention to after Endotracheal Intubation
After undergoing an endotracheal intubation procedure, the patient will experience a sore throat and difficulty in swallowing, but will recover quickly once the endotracheal tube is removed. If you experience any of the following symptoms after endotracheal intubation, contact your doctor immediately:
- The face swells.
- Pain in the chest.
- Difficulty speaking.
- Difficulty swallowing.
- Shortness of breath.
- Severe sore throat.
Endotracheal intubation is a procedure intended to keep the patient's airway open, as well as to assist in the delivery of respiratory support. If you feel anxious before undergoing an endotracheal intubation procedure, consult your surgeon or anesthetist to get an explanation of the benefits and risks that may occur.