An endotracheal tube is a plastic flexible tube that is passed down the throat, through the vocal chords and into the lungs. Individuals may require endotracheal tubes while they are under anesthetic during surgery. Some individuals who are too ill to breathe on their own may need an endotracheal tube. When a patient has this breathing tube in place it can be attached to an artificial respirator that will breathe for him.
Endotracheal tubes should only be inserted by qualified health care personnel. The doctor or paramedic will use an instrument called a laryngoscope to help visualize the trachea. This metal instrument has a curved or straight blade extending from a handle. The laryngoscope has a light that allows the doctor to see the vocal chords clearly while the blade holds the patient's tongue to the side.
Once the vocal chords are visualized, the doctor will pass the endotracheal tube down the throat and through the vocal chords. He will then inject a small amount of air into the endotracheal tube cuff that lies just below the trachea. This purpose of this cuff is to help form a seal and prevent air leakage around the tube. Correct endotracheal tube placement is confirmed by listening to the chest with a stethoscope. If there are equal breath sounds on both sides of the chest, the tube is usually in the right place.
Confirmation of correct endotracheal tube placement is important because an incorrectly placed tube can lead to complications. The esophagus is the passage to the stomach that lies right in front of the trachea. If the endotracheal tube is mistakenly placed in the esophagus it can cause stomach contents to regurgitate and enter the lungs. This regurgitation can lead to a serious case of pneumonia or respiratory distress.
If the endotracheal intubation tube is placed too deep into the lung, only one lung will be provided with oxygen. This will lead to inadequate ventilation of the patient. A prolonged state of inadequate ventilation can sometimes lead to brain damage or death. If the tube is placed too deep, the doctor can pull it back a few centimeters until air exchange is heard over both lung fields.
The endotracheal tube can remain in place for several days if needed. However, if an individual requires long term artificial ventilation it is recommended that a tracheotomy be preformed. This technique involves cutting a hole in the front of the neck just below the Adam's apple. A breathing tube will then be passed into the lungs through this hole.