Endotracheal Tube Defined

endotracheal tube for intubation during general surgery
Endotracheal Tube. Image: A.D.A.M @ About.com

Endotracheal Tube Explained

An endotracheal, also known as an ET tube, is a small, flexible tube that allows a patient to be placed on a ventilator when they need support with their breathing. The tube is plastic and is inserted into the mouth and down the throat and into the airway. The process of inserting an endotracheal tube is called intubation and is typically performed by an anesthesia provider or a respiratory therapist, but in some cases may be performed by other physicians or nurses.

There is a small doughnut-shaped balloon that is inflated after the tube is properly placed. This helps keep the tube in place and also creates a seal so that air doesn't escape around the tube.

The endotracheal tube is then connected to special tubing that connects to a ventilator, or in some cases, an Ambu bag is used to help the patient take breaths until they can be put on the ventilator.

Securing an Endotracheal Tube

The tube is typically secured to the corner of the patient's mouth using tape or a special type of tube that wraps behind the patient's neck. This is to keep the tube in the proper position. If the tube moves significantly, the patient may not get as much of the air from the ventilator as they are intended to receive.

After the tube is in place and secured and the patient is receiving air from the ventilator, a chest X-ray may be performed to confirm the tube is in the appropriate position and to rule out any issues with the lungs.

When an Endotracheal Tube is Used

Endotracheal tubes are used for two primary reasons: to support a patient who is too ill to breathe on their own without a ventilator, or to support a patient who is receiving anesthesia and will not be able to breathe on their own during a surgery.

Endotracheal tubes are used when the use of a ventilator is intended to be temporary; patients who are ventilator dependent will typically have a tracheotomy, a surgically created opening in the neck, through which they are connected to ventilator tubing.

Extubation: Removing an Endotracheal Tube

The process of removing an endotracheal tube is typically a quick one. First, the tape or ties holding the ETT in place are removed. The balloon is deflated so that the tube can be removed without causing any issues to the airway. Once the balloon is down, the tube can be gently pulled from the airway. This generally causes the patient to cough which is normal in the minutes following extubation. The patient is then placed on oxygen, in most cases, to make it easier to breathe on their own.

More Information About Anesthesia

Pronunciation: en-doe-trake-ee-uhl tube

Also Known As: ET Tube, ETT

Examples: The anesthesiologist inserted an endotracheal tube so the patient could breathe.

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