What Is Endotracheal Intubation?

Medically Reviewed By Carissa Stephens, R.N., CCRN, CPN
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Endotracheal intubation is when a medical professional places a tube into the trachea to help a person ‌breathe. Common use cases include cardiac arrest and airway obstruction. Alternative names include “tracheal intubation” and “intubation.” Research suggests that endotracheal intubation is the most common approach to advanced airway management for out-of-hospital cardiac arrest in advanced countries.

This article will explain endotracheal intubation, including how it works and what to expect after the procedure.

What do doctors use endotracheal intubation for?

An intubated man
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Doctors use endotracheal intubation to secure a person’s airway and allow them to continue breathing.

The trachea or windpipe is a crucial part of the respiratory system. It connects the larynx to the bronchi and facilitates air transfer into the lungs. If the trachea is blocked or damaged, breathing can become difficult.

Some reasons for endotracheal intubation include:

  • cardiac arrest: when the heart suddenly stops beating
  • hypoxia: low levels of oxygen in your body tissues
  • an injury that interferes with breathing: such as a severe neck, abdominal, or chest injury
  • airway obstruction: something gets stuck in the airway
  • loss of consciousness: may necessitate machine-assisted breathing
  • hypercarbia: too much carbon dioxide in the bloodstream
  • sleep apnea: a sleep disorder in which breathing temporarily stops

How does endotracheal intubation work? 

Medical professionals can perform endotracheal intubation in two ways:

  1. orotracheal intubation, which is when they insert the tube through your mouth 
  2. nasotracheal intubation, which is when they insert the tube through your nose

Medical professionals usually prefer orotracheal intubation because it is quicker.

Here is how the procedure works:

  1. A medical professional will administer general anesthesia to keep you asleep during the procedure.
  2. Doctors will then insert a small lighted instrument called a direct laryngoscope into your airway to find your vocal cords. In some cases, they may use a video laryngoscope instead, which is a laryngoscope with a camera.
  3. Next, they will place the endotracheal tube through your vocal cords into the base of your trachea.
  4. Afterward, they will inflate a small balloon around the endotracheal tube to secure its position.
  5. Finally, they will remove the laryngoscope and place tape on the side of your mouth to keep the endotracheal tube in place.

If your condition calls for it, your doctor may connect your endotracheal tube to a ventilator or breathing machine. They may also attach it to a bag with which they can pump oxygen into your lungs.

Most times, endotracheal intubation happens in the hospital. In some cases, however, paramedics may perform the procedure outside the hospital.

What are the risks of endotracheal intubation?

Although endotracheal intubation is generally safe, it carries a few possible risks, including:

Although it is rare, a tear or hole in the airway called tracheal rupture can also occur.

General anesthesia can cause some side effects:

Your medical professional will assess the risks and benefits of endotracheal intubation before performing the procedure. They will also monitor you closely throughout the procedure.

How can you prepare for endotracheal intubation?

In non-emergency cases, such as if you are undergoing treatment for sleep apnea, you may be able to prepare for the procedure. Adequate preparation can lower your risk of complications.

Your doctor may advise you to avoid food and drink before the procedure. They may also advise you to avoid over-the-counter (OTC) blood thinners, such as aspirin, for about a week before the procedure. These medications can cause bleeding and other complications during invasive operations.

If you have diabetes or another underlying health condition that weakens your immune system, let your doctor know before the procedure. They may recommend medication changes and monitor you more closely during the operation.

What can you expect after endotracheal intubation?

You may experience some discomfort after the procedure, such as:

These symptoms may go away within a short time. However, contact your doctor if they persist.

Your doctor may choose to perform certain procedures alongside or in place of endotracheal intubation, including:

  • Flexible fiberoptic laryngoscopy: This procedure examines the throat and its surrounding structures for anomalies. One type is indirect laryngoscopy, which involves using a small mirror. The other type is direct flexible laryngoscopy, which uses a telescope.
  • Tracheostomy: Tracheostomy is when a medical professional makes an opening in your neck to insert a tube into your trachea. Like endotracheal intubation, tracheostomy delivers oxygen to your lungs when you cannot breathe on your own.
  • Cricothyrotomy: This procedure involves a medical professional creating a hole in a ligament in your neck to insert a tube into your trachea. It is similar to tracheostomy except that cricothyrotomy is more straightforward to perform.

Frequently asked questions

Here are a few other commonly asked questions about endotracheal intubation. Carissa Stephens, RN, CCRN, CPN, has reviewed the answers.

Is endotracheal intubation the same as intubation?

Yes, endotracheal intubation is the same as intubation. Another name for the procedure is tracheal intubation.

What is the difference between endotracheal intubation and orotracheal intubation?

Orotracheal intubation is one method for performing endotracheal intubation. For orotracheal intubation, doctors insert a tube through your mouth. This is different from nasotracheal intubation, another endotracheal intubation method, where doctors insert a tube through your nose.

Summary

Endotracheal intubation is an emergency lifesaving procedure in which a medical professional places a tube into your trachea to help you ‌breathe. Typical use cases include incidents of cardiac arrest, airway obstruction, and sleep apnea.

Your medical professional will first give you an anesthetic to perform the procedure. Then they will use a laryngoscope to find your vocal cords and guide the endotracheal tube into your trachea. Finally, they will secure the tube and remove the laryngoscope.

You may experience some discomfort after the procedure. Common side effects include chest pain, hoarseness, neck pain, and difficulty swallowing. In some cases, complications such as injury, hypoxemia, and bleeding may also develop.

Talk with your doctor about the risks and benefits of endotracheal intubation. 

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Medical Reviewer: Carissa Stephens, R.N., CCRN, CPN
Last Review Date: 2022 Aug 11
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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