Tracheal intubation

endotracheal intubationintubationintubatedintubateextubationendotracheal tubenasotracheal intubationorotracheal intubationprobingbronchial intubation
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs.wikipedia
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Intubation

intubatedendotracheal intubationintubate
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs.
Examples include tracheal intubation, and the balloon tamponade with a Sengstaken-Blakemore tube (a tube into the gastrointestinal tract).

Laryngoscopy

laryngoscopeindirect laryngoscopyvideo laryngoscopes
Intubation is normally facilitated by using a conventional laryngoscope, flexible fiberoptic bronchoscope, or video laryngoscope to identify the vocal cords and pass the tube between them into the trachea instead of into the esophagus.
Laryngoscopy may be performed to facilitate tracheal intubation during general anaesthesia or cardiopulmonary resuscitation or for surgical procedures on the larynx or other parts of the upper tracheobronchial tree.

Cricothyrotomy

cricothyroidotomyneedle cricothyrotomycric
Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated.
Cricothyrotomy is nearly always performed as a last resort in cases where orotracheal and nasotracheal intubation are impossible or contraindicated.

Tracheotomy

tracheostomytracheotomiestracheostomy tube
Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated.
In the context of failed tracheal intubation, either tracheotomy or cricothyrotomy may be performed.

General anaesthesia

general anesthesiageneralgeneral anesthetic
Because it is an invasive and uncomfortable medical procedure, intubation is usually performed after administration of general anesthesia and a neuromuscular-blocking drug.
In the 20th century, the safety and efficacy of general anaesthesia was improved by the routine use of tracheal intubation and other advanced airway management techniques.

Intensive care medicine

intensive carecritical carecritical care medicine
By the mid-20th century, the tracheotomy as well as endoscopy and non-surgical tracheal intubation had evolved from rarely employed procedures to becoming essential components of the practices of anesthesiology, critical care medicine, emergency medicine, and laryngology.
Common equipment in an intensive care unit includes mechanical ventilation to assist breathing through an endotracheal tube or a tracheotomy; hemofiltration equipment for acute kidney injury; monitoring equipment; intravenous lines for drug infusions fluids or total parenteral nutrition, nasogastric tubes, suction pumps, drains and catheters; and a wide array of drugs including inotropes, sedatives, broad spectrum antibiotics and analgesics.

Medical procedure

procedureproceduresmedical
Because it is an invasive and uncomfortable medical procedure, intubation is usually performed after administration of general anesthesia and a neuromuscular-blocking drug.

Airtraq

Other "noninvasive" devices which can be employed to assist in tracheal intubation are the laryngeal mask airway (used as a conduit for endotracheal tube placement) and the Airtraq.
Airtraq is a fibreoptic intubation device used for indirect (video or optic assisted) tracheal intubation in difficult airway situations.

Tracheobronchial injury

bronchial tearlarynx, trachea or bronchitracheal fracture
Severe blunt or penetrating injury to the face or neck may be accompanied by swelling and an expanding hematoma, or injury to the larynx, trachea or bronchi.
In the emergency setting, tracheal intubation can be used to ensure that the airway remains open.

Anesthesia

anaesthesiaanestheticanesthetized
By the mid-20th century, the tracheotomy as well as endoscopy and non-surgical tracheal intubation had evolved from rarely employed procedures to becoming essential components of the practices of anesthesiology, critical care medicine, emergency medicine, and laryngology.
The advantage of sedation over a general anesthetic is that it generally does not require support of the airway or breathing (no tracheal intubation or mechanical ventilation) and can have less of an effect on the cardiovascular system which may add to a greater margin of safety in some patients.

Pulmonary aspiration

aspirationaspiratedaspirating
After the trachea has been intubated, a balloon cuff is typically inflated just above the far end of the tube to help secure it in place, to prevent leakage of respiratory gases, and to protect the tracheobronchial tree from receiving undesirable material such as stomach acid.
Tracheal intubation or presence of a gastric tube (for example, a feeding tube) may also increase the risk.

Trachea

windpipetrachealtracheae
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. Intubation is normally facilitated by using a conventional laryngoscope, flexible fiberoptic bronchoscope, or video laryngoscope to identify the vocal cords and pass the tube between them into the trachea instead of into the esophagus.
Tracheal intubation refers to the insertion of a catheter down the trachea.

Epiglottitis

glottic edema
Airway obstruction is also common in people who have suffered smoke inhalation or burns within or near the airway or epiglottitis.
The most important part of treatment involves securing the airway, which is often done by endotracheal intubation.

Airway management

airwaychest thrustsAirway establishment & management
Tracheal tubes are frequently used for airway management in the settings of general anesthesia, critical care, mechanical ventilation and emergency medicine.
Advanced techniques require specialized medical training and equipment, and are further categorized anatomically into supraglottic devices (such as oropharyngeal and nasopharyngeal airways), infraglottic techniques (such as tracheal intubation), and surgical methods (such as cricothyrotomy, and tracheotomy).

Angioedema

angiooedemaangioneurotic edemahereditary angioedema
Sustained generalized seizure activity and angioedema are other common causes of life-threatening airway obstruction which may require tracheal intubation to secure the airway.
Tracheal intubation is required in these situations to prevent respiratory arrest and risk of death.

Double-lumen endobronchial tube

double-lumen endo-bronchial tubedouble-lumen endotrachealtubes
There are a number of different types of double-lumen endo-bronchial tubes that have endobronchial as well as endotracheal channels (Carlens, White and Robertshaw tubes).
A double-lumen endotracheal tube (also called double-lumen endobronchial tube or DLT) is a type of endotracheal tube which is used in tracheal intubation during thoracic surgery and other medical conditions to achieve selective, one-sided ventilation of either the right or the left lung.

Suxamethonium chloride

succinylcholinesuxamethoniumsuccinylcholine chloride
RSI traditionally involves preoxygenating the lungs with a tightly fitting oxygen mask, followed by the sequential administration of an intravenous sleep-inducing agent and a rapidly acting neuromuscular-blocking drug, such as rocuronium, succinylcholine, or cisatracurium besilate, before intubation of the trachea.
This is done to help with tracheal intubation or electroconvulsive therapy.

Cricoid pressure

Sellick maneuverSellick manoeuvre
Another key feature of RSI is the application of manual 'cricoid pressure' to the cricoid cartilage, often referred to as the "Sellick maneuver", prior to instrumentation of the airway and intubation of the trachea.
Cricoid pressure, also known as the Sellick manoeuvre or Sellick maneuver, is a technique used in endotracheal intubation to try to reduce the risk of regurgitation.

Bronchial blocker

endobronchial blockerbronchial blockers
There is also the Univent tube, which has a single tracheal lumen and an integrated endobronchial blocker.
An bronchial blocker (also called endobronchial blocker) is a device which can be inserted down a tracheal tube after tracheal intubation so as to block off the right or left main bronchus of the lungs in order to be able to achieve a controlled one sided ventilation of the lungs in thoracic surgery.

Mechanical ventilation

mechanical ventilatorassisted ventilationRespiratory monitoring
It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction.

Flail chest

multiple rib fractures
Examples of such conditions include cervical spine injury, multiple rib fractures, severe pneumonia, acute respiratory distress syndrome (ARDS), or near-drowning.
A person may be intubated with a double lumen tracheal tube.

Pneumonia

bronchopneumoniabronchial pneumoniaNecrotizing pneumonia
Examples of such conditions include cervical spine injury, multiple rib fractures, severe pneumonia, acute respiratory distress syndrome (ARDS), or near-drowning.
Ventilator-associated pneumonia is specifically defined as pneumonia that arises more than 48 to 72 hours after endotracheal intubation.

Rocuronium bromide

rocuroniumZemuron
RSI traditionally involves preoxygenating the lungs with a tightly fitting oxygen mask, followed by the sequential administration of an intravenous sleep-inducing agent and a rapidly acting neuromuscular-blocking drug, such as rocuronium, succinylcholine, or cisatracurium besilate, before intubation of the trachea.
Rocuronium bromide (brand names Zemuron, Esmeron) is an aminosteroid non-depolarizing neuromuscular blocker or muscle relaxant used in modern anaesthesia to facilitate tracheal intubation by providing skeletal muscle relaxation, most commonly required for surgery or mechanical ventilation.

Tracheal tube

endotracheal tubebreathing tubebreathing tubes
The most widely used route is orotracheal, in which an endotracheal tube is passed through the mouth and vocal apparatus into the trachea.

Coma

comatoseunresponsivecomatose state
When this becomes severe to the point of stupor or coma (defined as a score on the Glasgow Coma Scale of less than 8), dynamic collapse of the extrinsic muscles of the airway can obstruct the airway, impeding the free flow of air into the lungs.
Stability of their respiration and circulation is sustained through the use of intubation, ventilation, administration of intravenous fluids or blood and other supportive care as needed.