Insertion Of An Endotracheal Tube

What you should know

  • An endotracheal (ET) tube is a hollow plastic tube that is placed in the trachea through the mouth. The trachea is a tube inside the body that goes from the throat to the lungs. The trachea is also called the windpipe or airway. The ET tube is attached to a machine called a respirator. A respirator gives a person oxygen (air), and breathes for him when he cannot breathe on his own.
    Proper Endotracheal Intubation


  • A person will need an ET tube if they are not able to breathe in enough oxygen for their body. This can occur if he has an injury, serious illness, or cardiac arrest (heart attack). An ET tube may also be used during surgery. Having an ET tube allows the patient to get the oxygen he needs, and allows the caregiver to treat the patient. Having an ET tube placed may save a person's life.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • During ET tube insertion, the patient may have abnormal heartbeats. The tube may cause damage to the patient's mouth, teeth, larynx (voice box), or trachea. The tube may be placed into the esophagus (passage from the mouth to the stomach). If this occurs, the patient may vomit and food or fluid may enter his lungs (aspiration). If the patient aspirates, he may get a lung infection. Having an ET tube for a long period of time also may lead to a lung infection. The tube also may be put too far into the patient's airway, or become dislodged. If the ET tube is not in the right area of his trachea, the patient may not get the oxygen he needs. Decreased levels of oxygen can lead to permanent organ or brain damage, and death.

  • When a person is not able to breathe well on their own, an ET tube is needed. Choosing not to have an ET tube placed will lead to decreased oxygen levels in the body. Decreased oxygen may lead to organ and brain damage, and may cause death.

Getting Ready

The week before the surgery

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Tell your caregiver if you are taking any blood thinning medicines, such as aspirin. Also tell your caregiver if you have any allergies.

  • Tell your caregiver if you know or think you might be pregnant.

  • Talk to your caregiver about any tests that you may be need before your surgery. Write down the date, time and location for each test.

The night before the surgery

  • Ask caregivers about directions for eating and drinking.

The day of the surgery:

  • Write down the correct date, time, and location of your surgery.

  • Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.

  • What to bring: You may want to bring items such as a toothbrush and bathrobe.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

  • You will be taken to the room where your surgery will be done. Anesthesia medicine may be given to help you fall, and stay asleep during your surgery. You will be completely asleep before your caregiver inserts the ET tube. Caregivers will give you extra oxygen before inserting your ET tube. The ET tube may be put in with a stiff device to help guide it into place. The tube will be put into your mouth, past your vocal cords, and into your trachea. Once the tube is in place, the stiff guiding device will be removed. The tube may have a balloon at the end that is filled with air to hold it in place. The tube will be secured to your mouth with special tape. The ET tube will be attached to a respirator, which will breathe for you during your surgery.

  • After the ET tube is put in, your caregiver will check to be sure the tube is in the right place. He will listen for breath sounds in your lungs and watch for chest movement. He may measure the level of carbon dioxide you are breathing out. Your caregiver also may try to pull air out from the ET tube with a syringe. A small camera may be put down into the ET tube to check placement. Caregivers also may use an ultrasound or x-ray to check if the ET tube is in the proper place.

After your surgery:

  • You will be taken to a room to rest until you are fully awake. The ET tube may be removed by a caregiver before you are fully awake. If you are awake before the tube is removed, follow your caregiver's instructions closely. Following instructions will help you stay calm while caregivers get ready to remove the ET tube.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You have a fever or a cold (cough).

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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