Intubation is a process where a healthcare provider inserts a tube through a person’s mouth or nose, then down into their trachea (windpipe). The tube keeps the trachea open so that gases can get through. The tube is then connected to a device that delivers oxygen and other materials to the lungs (mechanical ventilation). The device to deliver oxygen can be a bag valve, or a mechanical ventilator. Certain liquid medicines (Narcan, Atropine, Valium, Epinephrine, and Lidocaine) can be delivered this way, although that procedure isn’t as common as it used to be. Gaseous anesthetics can also be delivered this way.

Intubation is a procedure that is done under one of two conditions: Procedural or emergent. It’s done for patients who for whatever reason can’t control their own airway, to permit the healthcare team to protect and control that airway. If, due to drugs, illness, or injury, you can’t keep your own airway open, you will likely be intubated.

The main indications for intubation are:

  • general anaesthesia
  • congenital malformations
  • diseases or trauma to the upper airway
  • the need for mechanical ventilation
  • perinatal resuscitation
  • acute respiratory distress

It’s a procedure carried out in any given hospital dozens of times each day, mostly under procedural conditions. A procedural intubation is carried out for the purposes of surgery. A patient that is to be placed under general anaesthesia can’t keep their own airway open or breathe very well on their own, so they are sedated and then intubated before being placed on a mechanical ventilator of some sort. An emergent intubation is done for a sudden, unplanned reason like trauma to the airways, cardiac arrest, or acute respiratory failure.

How is it done? There are a number of methods, but here are the basics:

Once that tube is in place, we now have a secure airway that enables us to use some form of mechanical ventilation to breathe for the patient.

There are risks to intubation that include trauma and damage to the airway, and unrecognized esophageal intubation, which is where the provider inserts the tube into the esophagus instead of the trachea and doesn’t recognize the error. There are ways to mitigate these errors, but the risks can only be minimized. That is why in medicine we always weigh the risks against the benefits of any procedure.

When people complain that intubation is bad for COVID patients, they aren’t really talking about intubation. They are talking about mechanical ventilation, which is a different, but related proedure. We will talk about that in a future post.

Categories: Medical News


Princess Cutekitten · October 25, 2023 at 6:37 am

I am enjoying your medical posts and learning a lot, please continue them.

On 10 February 1994, a day which will live in infamy, I slipped on the ice and broke my elbow, which had to be repaired surgically. Now I know why my throat was bruised and sore for a couple of days after I woke up. Thanks!

Grumpy51 · October 25, 2023 at 7:09 am

Good description.

Similarly, when patients say they don’t want to be intubated (code status), they really mean they don’t want to be on a ventilator (mechanical respirations). Clarification always ensues to make sure the patient, the family, and the healthcare team are all on the same page.

SoCoRuss · October 25, 2023 at 11:44 am

I agree I would really like to hear about the mechanical ventilator. I hear about the ones used for covid and couldn’t understand why they were supposedly killing folks with covid if you went on them as a common thing for surgeries. Didnt know about difference. Covid and New York state killed my father in law. He was in a assisted living center. NYS moved in covid folks and he caught it. Went to hospital seemed to be improving they added the ventilator and he turned worse and died…

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