Oral intubation, also called endotracheal intubation, is the insertion of a tube through a patient's mouth and into the trachea. Doctors may perform this procedure in emergency situations when the patient cannot breathe properly on his own, or it may be used prior to a surgery. In addition to opening the airway for adequate breathing, the tube may assist in the delivery of anesthesia or medication. An oral intubation is typically performed when the patient is unconscious or sedated.
Doctors prepare for an oral intubation by having an anesthesiologist nearby to address any complications that may arise. They may administer oxygen, sedatives, and topical anesthesia. If the patient is awake, he may be restrained to prevent a struggle, which may cause injury. After positioning the patient's head, the doctor will slide a laryngoscope into the mouth, allowing the doctor to see into the trachea, and assisting with the insertion of the tube.
The laryngoscope is used to push the tongue aside, and the doctor will apply slight pressure to the cartilage of the thyroid. This makes the vocal cords more visible so that the flexible tube can be guided through them. The laryngoscope is then removed and the doctor will confirm the correct placement of the tube by listening to the lungs with a stethoscope. Often, the patient will be connected to a ventilator, or a breathing machine, once the tube is in place.
An oral intubation procedure may not be appropriate for every patient. Doctors must exercise extreme caution when performing an intubation on a person who is awake and exhibits resistance. Conscious patients will likely have a gag reflex, which can complicate the procedure. Those who have a spinal cord injury may become more severely injured during an oral intubation, if the procedure causes the head and spine to move.
Other serious complications may infrequently occur during an oral intubation. It is possible that the tube may be inserted into the esophagus, rather than the trachea, in which case the patient will be unable to breathe properly. This can result in cardiac arrest, brain damage, and fatality. If the tube is inserted too deeply, a collapsed lung may result. The patient's vocal cords, soft tissues, and teeth may also become damaged.
Healthcare professionals must also monitor the patient regularly while they are intubated. Those who are hooked up to a ventilator are at an increased risk of developing pneumonia. These patients must have their teeth brushed by a nurse every eight hours and their heads should also be elevated 30 degrees to prevent pneumonia. Following an oral intubation, the doctor may prescribe gastric acid histamine2 blockers, which reduce the amount of acid in the stomach, to help prevent complications.
