Tracheal intubation

Glidescope video laryngoscope

Miller laryngoscope blades

Macintosh laryngoscope blades

Tracheal tube with stylet

Intubation setup

Tracheal intubation is a medical procedure in which a tube is inserted into the trachea through the mouth or nose to maintain an open airway, deliver oxygen, or administer anesthesia. It is commonly performed in emergency situations, during surgery, or in intensive care settings.

Procedure

The process of tracheal intubation typically involves the following steps:

1. Preparation: The patient is positioned, usually lying on their back, and pre-oxygenated to increase oxygen reserves. 2. Laryngoscopy: A laryngoscope is used to visualize the vocal cords. There are different types of laryngoscope blades, such as the Miller blade and the Macintosh blade. 3. Insertion: The endotracheal tube is inserted through the vocal cords into the trachea. 4. Confirmation: Proper placement is confirmed by observing chest rise, auscultation, and capnography. 5. Securing the Tube: The tube is secured to prevent displacement.

Equipment

Several tools and devices are used in tracheal intubation:

• Laryngoscopes: Used to visualize the vocal cords. The Glidescope is a video laryngoscope that provides a clear view of the airway.
• Endotracheal Tubes: Tubes of various sizes are used to maintain the airway.
• Stylets: A tracheal tube stylet is often used to guide the tube into place.
• Cricothyrotomy Kits: Used in emergency situations when intubation is not possible.

Indications

Tracheal intubation is indicated in several situations, including:

• Airway Obstruction: To bypass obstructions in the upper airway.
• Respiratory Failure: To provide mechanical ventilation.
• Surgical Procedures: To maintain an open airway during anesthesia.
• Severe Trauma: To secure the airway in trauma patients.

Complications

While generally safe, tracheal intubation can lead to complications such as:

• Esophageal Intubation: Incorrect placement of the tube in the esophagus.
• Vocal Cord Injury: Damage to the vocal cords during insertion.
• Infection: Risk of infection if aseptic techniques are not followed.
• Tracheal Stenosis: Narrowing of the trachea due to prolonged intubation.

Related Pages

• Anesthesia
• Mechanical ventilation
• Airway management
• Laryngoscopy