Intubation is a technique doctors can use to keep your airway open by placing a tube into your trachea (windpipe) either through your mouth or nose.
You may need to be intubated if your airway is restricted from an injury or an infection. It might also be used if you’re unable to breathe on your own due to loss of consciousness or if there are issues with your heart, lungs, or brain.
Medical professionals often use intubation in emergency settings, but they can also plan it in advance as part of a surgery.
While it’s a useful and common procedure, intubation can carry certain risks. Read on to learn more about this procedure and how it’s used.
Intubation is used when you aren’t able to breathe on your own.
There are certain situations when you might expect to be intubated, such as when you’re having a planned surgery.
General anesthesia can stop you from breathing naturally, so an anesthesiologist might intubate you to ensure that vital oxygen is delivered to your body while you’re unconscious.
For surgery, the intubation will be done once anesthesia has been delivered and you’re asleep.
Intubations are also used in emergency settings. You may need to be intubated if you are experiencing:
- low oxygen levels
- high carbon dioxide levels
- a high risk of inhaling a foreign object or substance into your airway, or aspiration
- traumatic injury to your neck, abdomen, or chest
- airway burns
- cardiac arrest
- severe swelling in the deep layers of your skin, also called angioedema
To intubate, your anesthesiologist will insert a tube through either your mouth or nose. While these two procedures are similar, the circumstances around the intubation usually dictate which method is used.
Intubations through the mouth are most common, especially during an emergency. This is because the mouth is larger, which makes it easier to get the tube into place.
Usually, you’ll lie on a hospital bed for this procedure. But in the case of an emergency, intubation may be performed by paramedics in ambulances, helicopters, or at the site of an emergency.
The steps involved in an intubation through the mouth are typically as follows:
- Pre-oxygenation. The oxygen in your lungs will be increased using a non-rebreather mask, a medical device used to deliver oxygen to the body.
- Medication. If you’re conscious prior to being intubated, you’ll be given a mild anesthesia medication that will put you to sleep quickly.
- Laryngoscope. A medical professional will then insert a curved, handheld device into your mouth to move your tongue and open your throat.
- Endotracheal tube. When all obstructions are removed, a flexible tube is inserted past your larynx (voice box) and into your trachea.
- Inflation. A small balloon at the end of the tube is inflated to help keep the tube in place.
- Confirmation. Doctors will make sure the tube is in the right place, usually with a stethoscope, and then confirm with a carbon dioxide monitor or a chest X-ray.
Intubation through the nose might be used in situations where your mouth is badly injured or is blocked in some way. It’s also useful during oral surgeries where an intubation tube in your mouth would be in the way.
The steps of the procedure are the same as those used for oral entry, but there’s no need for a laryngoscope. A scope that’s smaller and fits through the nose is inserted through one nostril instead of the mouth. From there, it passes down your throat and into your trachea.
The main benefit of being intubated is that your airway stays open. There are many reasons why your airway might become restricted or closed. But no matter the reason, this requires urgent medical attention.
If your airway closes, you won’t be able to breathe. Without oxygen, you can lose consciousness or experience damage to your vital organs. If enough time passes without getting oxygen into your lungs, it can be fatal.
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There are several risks associated with intubation that doctors will assess before moving forward with the procedure.
- Low oxygen. Intubation can sometimes be difficult to perform. If you aren’t adequately breathing at the time of intubation, your body will become more and more starved of oxygen until the procedure is complete. According to research, emergency intubations are unsuccessful on the first attempt between
10 and 25 percentof the time.
- Tube placement. Another risk is that the tube will be placed incorrectly. If the tube accidentally ends up in one of the bronchi of your lungs, it can lead to complications like a partially collapsed or fully collapsed lung. If the tube goes into your esophagus instead of your trachea, this can be fatal if not caught quickly.
- Injury. The tube has the potential to damage soft tissue in your throat and trachea as it’s inserted or removed. When you are intubated through the mouth, the laryngoscope can also damage your tongue, teeth, or dental work.
- Infection. Intubation, especially for an extended period of time, can increase your risk of infections like pneumonia.
Most people fully recover from intubation within a few hours to days and experience no long-term side effects.
Being intubated and being on a ventilator aren’t the same thing, but they often go hand in hand.
Intubation uses a tube to keep your airway open. A ventilator, sometimes called a respirator or breathing machine, can be hooked up to the intubation tube. A ventilator helps deliver fresh oxygen into your lungs and removes carbon dioxide.
When ventilators handle your breathing, your body has more energy to fight infections or to recover from injuries.
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Intubation is a medical technique that involves having a tube inserted into your trachea through your mouth or nose in order to keep your airway open. It may be used if your airway is restricted or you’re unable to breathe on your own.
While intubation is a useful and often lifesaving procedure, it does come with risks. In most emergency cases, intubation is only used if the individual wouldn’t survive without being intubated.
If you’re opposed to intubation, even as a lifesaving measure, you can create a do-not-intubate (DNI) order. This is a legal document telling healthcare professionals that you do not wish to be intubated, which prevents the procedure.
While this is not a decision to make lightly, you should always make your healthcare wishes known to those you trust and your medical professionals.