Intubation

When intubation insertion of a tube is ( a hollow tube) referred to in a natural body cavity or a hollow organ. Usually the term is used in the sense of inserting a tube through the mouth or nose to aspirationsgeschützten ventilation ( airway ). The term intubation is sometimes also used to describe endoscopic procedures.

The removal of a breathing tube is called extubation.

Types of intubation

Oropharyngeal

If the tube through the mouth (os) up into the throat ( pharynx ) down, one speaks of the oropharyngeal airway (also called oral or pharyngeal tube, after the Latin or Greek: os, pharynx ). He should keep away the tongue from the posterior pharyngeal wall, thus allowing spontaneous breathing or ventilation with a resuscitator. The oropharyngeal airway include the Guedel airway, COPA- tube, Weinmann Lifeway and the Safar - tube.

Nasopharyngeal

When nasopharyngeal ( through the nose, around the Wendl tube), the tube is placed through the nose and is equal to the oropharyngeal airways in the throat for lying. It resembles accordingly at the advantages and disadvantages of the Rachtuben, but is hardly used in the preclinical stage, but almost exclusively in intensive care.

Endotracheal intubation

When endotracheal intubation is an endotracheal tube through the mouth ( orotracheal ) or nose ( nasotracheal ) between the vocal folds of the larynx ( larynx ) is introduced through the windpipe ( trachea). This is performed in patients under anesthesia or unconsciousness acute disorders of respiration, in order to secure the airway from aspiration and enable an external ventilator. Since the anatomical conditions from person to person are different and as a result, also the anatomy of the mouth and throat area as well as the trachea and glottis, there is the classification of the difficulty with intubation, the classification according to Cormack and Lehane - being divided into four different levels is how well the glottis can be seen. For ease of endotracheal intubation, there are various possibilities such as the Sellick handle or the BURP maneuver. Intubation is now regarded as a standard method ( gold standard ) of airway management by experienced operators, the term intubation in the strict sense, therefore, often referred to this. The insertion of a tube with two lumens allows the page separate ventilation of the lung, which is required for some procedures in thoracic surgery. This is partially described as endobronchial intubation, as the tip of the tube comes to rest in a main bronchus.

Alternative intubations

Alternatives to endotracheal intubation aids such as laryngeal and Combitube be used by non - physician's medical personnel often to inability to place the tube properly ( difficult intubation ), or. Explicitly mentioned in the resuscitation guidelines of the ERC of 2011 that beginners have to rely on these alternatives for airway management to prevent the misintubation, so the unnoticed introduction of endotracheal tube into the esophagus with gastric insufflation.