Table of ContentsView AllTable of ContentsOverviewTypes and UsesWhat to ExpectIntubation vs. VentilationRisksContraindicationsIntubating ChildrenTube RemovalRecovery
Table of ContentsView All
View All
Table of Contents
Overview
Types and Uses
What to Expect
Intubation vs. Ventilation
Risks
Contraindications
Intubating Children
Tube Removal
Recovery
Intubationis the process of inserting a tube called an endotracheal tube (ET) into the mouth or nose and then into the airway (trachea) to hold it open. Once in place, the tube is connected to a machine called aventilator(or a bag that gets squeezed, depending on availability) to push air in and out of the lungs.
There are several reasons why intubation is needed, but it is mainly used to support breathing during surgery or in an emergency.
This article goes over the different types of intubation, the intubation procedure, and the risks of being intubated.
Verywell / Joshua Seong
What Is Intubation?
Intubation occurs when a tube is inserted into your trachea to help you breathe. Depending on why intubation is needed, it may or may not be serious. Intubation is commonly used for anesthesia in surgery and for airway management in more critical patient care.
In emergency situations and certain illnesses, being intubated means a form of life support. It can help keep the airway open and assist breathing.
Why You Might Need to Be Intubated
The reason someone is being intubated dictates which of the two types of intubation will be used.
Endotracheal intubationis when the tube is inserted through the mouth. It used in most emergency situations because the tube that gets placed through the mouth is larger and easier to insert than the one inserted through the nose.
Endotracheal intubation is used to:
Nasotracheal intubationis when the tube is put in through the nose. It is used to:
What to Expect When Intubated
Intubation is a common procedure. In the United States alone, at least 15 million intubations are performed in an operating room and another 650,000 are performed outside of an operating room each year.
The survival rate for intubation patients depends on the underlying reason for intubation as well as other factors, like age and overall health status.
For example, about half of all patients who needed to be intubated during the COVID-19 pandemic died in the ICU. Severe cases of COVID that required intubation as well as advanced age were two factors that contributed to mortality in these patients.
Here’s what to expect if you need to be intubated:
Endotracheal Intubation
Before endotracheal intubation, a person usually needs to besedatedif they are not already unconscious. This means that you will be given medication to make you relaxed and sleepy. It helps make sure you don’t accidentally pull out the tube. You also won’t be able to eat or talk while intubated.
The next steps of endotracheal intubation are as follows:
Nasotracheal Intubation
The process of nasotracheal intubation is similar to endotracheal intubation, but the person may either be fully or partially sedated.
Since nasal intubation is more often performed in a controlled environment, there can be other tools involved in the process.
For example, a provider can use topical vasoconstrictors, medications used to make blood vessels smaller, or special tips or catheters to reduce the chance of bleeding.Nosebleed(epistaxis) is the most common complication of nasotracheal intubation.
Once the tube is fed into the nostril and enters the middle part of the throat, a fiberoptic scope called alaryngoscopehelps guide the tube between the vocal cords and into the windpipe.
The tube is inflated to secure it in the trachea and then taped on the outside to keep it from moving.
Is Being Intubated Painful?Most people are not awake and conscious while they are being intubated. If they are, providers can help ease the discomfort of intubation with treatments like throat-numbing sprays and sedation.
Is Being Intubated Painful?
Most people are not awake and conscious while they are being intubated. If they are, providers can help ease the discomfort of intubation with treatments like throat-numbing sprays and sedation.
Feeding During Intubation
Nutrition, fluids, and medication can be delivered through the feeding tube, which is either passed through the mouth or nose and then into the stomach.
Total parenteral nutrition (TPA), when nutrition is given through a needle in the patient’s arm, is an option for people with severe malnutrition and weight loss, people with ablockage in their intestines, and people with diseases that make tube feeding impossible.
Types of Feeding Tubes and Their Uses
Is Being on a Ventilator the Same as Being Intubated?
Intubation and ventilation go hand-in-hand, but they are distinct elements of the steps taken to help someone breathe.
Intubation is simply the process of placing the tubethat protects the airway, keeping an open passageway to the lungs.
While being awake on a ventilator is possible, people are usually sedated to help prevent anxiety or discomfort. When a person is placed on a ventilator, they can be givenmonitored anesthesiato induce “twilight sleep” or general anesthesia to put them fully asleep.
1:42Click Play to Learn More About Intubation
1:42
Click Play to Learn More About Intubation
What Are the Risks of Intubation?
Most people experience only mild side effects like sore throat and hoarseness as a result of intubation. Some people have no symptoms and never even realize they were intubated.
However, there are some risks of intubation that can be serious, especially in people who need to be on a ventilator for a long period of time.
Common risks of intubation include:
Tracheal stenosis, or a narrowing of the trachea, is also possible.
Who Should Not Be Intubated?
Sometimes, a person cannot be intubated safely. In these situations, intubation is not advised.
A person might not be able to be intubated if they:
In a life-or-death situation, providers might decide that the benefits of intubating a patient outweigh the risks.
Risks of Endotracheal Intubation
The process of intubation is more or less the same for adults and children, aside from the size of the tube and some of the equipment that can be used.
Nasal intubation is the preferred method for newborns and infants, though it can take several attempts to properly place the tube.
How Is the Tracheal Tube Removed?
Extubationis the process of removing a tracheal tube. It is usually easier and faster to take the tube out than it is to put it in.
Extubation involves the following steps:
How Long Can Someone Be Intubated?
What Is Recovery Like After Being Intubated?
Coughing, hoarseness, and discomfort are common symptoms after extubation, but they tend to improve within a few days. Some people may also experience difficulty swallowing or talking while the throat and voice box recover from inflammation and irritation.
If you continue to experience difficulty talking or swallowing within a few weeks of being intubated, contact your healthcare provider. Your provider may refer you to anotolaryngologist(ear, nose, and throat specialist) to help you recover fully.
Summary
It is called endotracheal intubation when the tube is inserted into the mouth and nasogastric intubation when the tube is fed through a nostril. The procedure for both is largely the same.
There are risks associated with intubation, but the benefits of intubation generally outweigh the risks.
When a Loved One Is in the Intensive Care Unit
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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