Fiberoptic intubation is a specialized method of inserting a breathing tube into a patient. The procedure is most commonly used when a patient is still awake or cannot move his or her head. The equipment involves a breathing tube acting as a sheath around a fiberoptic camera. The camera allows the physician to guide the tube into the proper place. Once completed, the camera comes out and the patient is connected to a ventilator.
In its simplest form, tracheal intubation is the insertion of a breathing tube down a patient's trachea, or windpipe. Intubation is a necessary procedure for most surgeries or when a patient is in a critical state. During most trachael intubations, a physician uses a device known as a laryngoscope to depress the tongue. The trachea visible, he or she can insert the breathing tube. This practice becomes impossible in certain situations.
If a patient presents with a neck injury, for example, normal tracheal intubation can cause further spinal damage. Physicians needed a form of intubation where they did not need to move the patient's head. Fiberoptic intubation was created as a solution to this problem.
In the majority of cases, a physician uses fiberoptic intubation on a patient who is awake. A local anesthetic, usually a spray, is applied to the back of the throat. A second physician or nurse applies a small suction cup to the tip of the patient's tongue and slightly pulls the tongue forward. This procedure creates a larger gap for the fiberoptic camera. The patient prepped, the physician begins intubation.
Feeding the tube into the patient's mouth, the physician watches the camera's image on a nearby television. To avoid moving the patient during the procedure, the physician makes slower movements than during a normal intubation. The image allows him or her to find the windpipe and insert the tube down it. Once the tube is in place, the physician pulls out the camera portion. The remaining hollow tube is ready to be connected to a standard ventilator.
As with all medical procedures, fiberoptic intubation has its own set of complications and risks. Overall, the procedure is slightly less than 90% successful. Also, if a patient's mouth is full of blood or other fluid, the fiberoptic camera cannot display a clear image; it becomes impossible for a physician to insert a breathing tube. Bleeding due to the tearing of blood vessels is another possible complication of fiberoptic intubation.
