Tracheal intubation
Placement of a tube into the trachea to secure the airway.
Tracheal intubation is the placement of a flexible plastic tube into the trachea to maintain an open airway or serve as a conduit for drug administration. It is a critical procedure in anesthesiology, critical care, emergency medicine, and laryngology, frequently performed on critically injured, ill, or anesthetized patients to facilitate ventilation and prevent asphyxiation or airway obstruction.
- field
- Medicine
- known_for
- Placement of a tube into the trachea to maintain airway patency and enable mechanical ventilation
- common_routes
- Orotracheal and nasotracheal
- surgical_methods
- Cricothyrotomy and tracheotomy
- typical_anesthesia
- General anesthesia and neuromuscular-blocking drugs, though awake intubation with local anesthesia is possible
Lore & Background
For centuries, tracheotomy was considered the only reliable method for intubation of the trachea, but because only a minority of patients survived the operation, physicians undertook it only as a last resort on nearly dead patients. It was not until the late 19th century that advances in understanding of anatomy and physiology, as well as appreciation of the germ theory of disease, improved the outcome of this operation to an acceptable level. At that time, advances in endoscopic instrumentation also made direct laryngoscopy a viable means for non-surgical orotracheal intubation.
Reader's Guide
Tracheal intubation is a cornerstone of modern medicine, evolving from a rarely employed last resort to an essential component of anesthesiology, critical care, emergency medicine, and laryngology by the mid-20th century. It is indicated in situations of depressed consciousness, hypoxemia, airway obstruction, manipulation of the airway, and in newborns with breathing problems. The procedure carries risks including broken teeth, lacerations, pulmonary aspiration, and unrecognized esophageal intubation, which can be fatal. Consequently, careful evaluation of airway anatomy and alternative strategies are always required. The most common route is orotracheal, using a laryngoscope to visualize the vocal cords, though nasotracheal and surgical routes are also used. After intubation, a balloon cuff is inflated to secure the tube and prevent leakage or aspiration, and the tube is connected to a ventilator or breathing circuit. Extubation occurs when ventilatory assistance is no longer needed.
Did You Know?
- Tracheal intubation can be performed in awake patients using local or topical anesthesia, or in emergencies without any anesthesia.
- The most widely used route is orotracheal, where the tube passes through the mouth and vocal apparatus into the trachea.
- A balloon cuff is inflated just above the far end of the tube to secure it, prevent gas leakage, and protect the tracheobronchial tree from stomach acid.
- Unrecognized intubation of the esophagus can lead to potentially fatal anoxia.
More in Medical Procedures And Treatments 1-23
Spotted an error? Know more?
This is a living reference — every entry is fact-audited, and reader corrections feed straight into our audit queue. Suggest an edit · See this site's audit record