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From surgery to emergency care: When is endotracheal intubation necessary?
Tracheal intubation is a critical medical procedure that involves placing a flexible plastic tube into the windpipe to maintain an open airway. This technology is mainly used in critically ill, injured or anesthetized patients to facilitate lung ventilation (including mechanical ventilation) and prevent the risk of suffocation or airway obstruction.
Tracheal intubation is usually done through the mouth (orotracheal intubation) or the sinuses (nasotracheal intubation). Although endotracheal intubation improves the safety of first aid and anesthesia, it is also an invasive and uncomfortable medical procedure. Therefore, this surgery is usually performed with the support of general anesthesia and neuromuscular blocking drugs. However, in some emergency situations, intubation may be necessary even without anesthesia.
"Endotracheal intubation provides the most reliable means of oxygenation and ventilation, especially under general anesthesia."
Intubation typically uses a traditional laryngoscope, flexible fiberoptic bronchoscope, or video laryngoscope to determine the position of the vocal cords and ensure that the tube is properly placed in the trachea. After intubation, the endotracheal tube balloon is usually inflated over the end of the tube to stabilize the tube and prevent leakage of respiratory gases. The endotracheal tube is then secured to the patient's face or neck and connected to a ventilation device or anesthesia breathing system.
Types and indications of endotracheal intubation
Indications for endotracheal intubation include many situations, especially when the patient's respiratory function is legally limited. Here are some key pointers:
Coma or reduced consciousness
Low level of consciousness is one of the common reasons for endotracheal intubation. Due to damage to the central nervous system, patients are often unable to maintain proper breathing and will require intubation to restore airway patency and protect the respiratory tract.
Hypoxemia
Endotracheal intubation may also be needed when a patient has insufficient breathing ability or is paralyzed. A certain drop in blood oxygen saturation can indicate this, especially in conditions such as acute respiratory distress syndrome (ARDS).
Airway obstruction
Tracheal intubation may also be required for life-threatening airway obstruction, such as in the case of foreign body inhalation, smoke inhalation, or laryngeal swelling.
Diagnostic program interference
Because certain procedures, such as bronchoscopy, may interfere with the patient's breathing, intubation is necessary in such cases.
Newborn
Newborns may need endotracheal intubation to assist breathing in certain conditions, such as respiratory distress syndrome and congenital heart disease.
Equipment for tracheal intubation
When performing tracheal intubation, medical staff usually use a laryngoscope. Laryngoscopes are divided into straight and curved styles, and their use depends on the specific anatomy of the patient and the experience of the medical staff. The evolving video laryngoscope provides additional visualization advantages, especially in difficult intubation situations.
"The use of multiple confirmation methods for correctness of tracheal intubation is the current standard."
Although modern equipment has made endotracheal intubation safe and effective, potential complications such as airway injury or pulmonary aspiration need to be clearly understood. In emergencies, health care workers must remain flexible and have alternative respiratory management options.
Tracheal intubation in emergencies
In emergency medical scenarios, the speed and accuracy of tracheal intubation are crucial. Intubation may be required immediately, such as after a traffic accident or other trauma, and typically requires a high degree of expertise and experience.
Every medical staff must have good intubation skills and experience when providing life support. Recognizing medical intubation as an essential skill symbolizes the emergency medical personnel's commitment to their patients' lives.
Such technology is not only crucial in surgery, but has also become an indispensable part in emergency situations. Every intubation saves a life. How to make the right decision at a critical moment will become an important issue that every medical professional must think about?
