Indications Tracheal intubation

1 indications

1.1 depressed level of consciousness
1.2 hypoxemia
1.3 airway obstruction
1.4 manipulation of airway

indications

diagram of endotracheal tube has been inserted trachea:

a - endotracheal tube (blue)

b - cuff inflation tube pilot balloon

c - trachea

d - esophagus

tracheal intubation indicated in variety of situations when illness or medical procedure prevents person maintaining clear airway, breathing, , oxygenating blood. in these circumstances, oxygen supplementation using simple face mask inadequate.

depressed level of consciousness

perhaps common indication tracheal intubation placement of conduit through nitrous oxide or volatile anesthetics may administered. general anesthetic agents, opioids, , neuromuscular-blocking drugs may diminish or abolish respiratory drive. although not means maintain patent airway during general anesthesia, intubation of trachea provides reliable means of oxygenation , ventilation , greatest degree of protection against regurgitation , pulmonary aspiration.

damage brain (such massive stroke, non-penetrating head injury, intoxication or poisoning) may result in depressed level of consciousness. when becomes severe point of stupor or coma (defined score on glasgow coma scale of less 8), dynamic collapse of extrinsic muscles of airway can obstruct airway, impeding free flow of air lungs. furthermore, protective airway reflexes such coughing , swallowing may diminished or absent. tracheal intubation required restore patency (the relative absence of blockage) of airway , protect tracheobronchial tree pulmonary aspiration of gastric contents.

hypoxemia

intubation may necessary patient decreased oxygen content , oxygen saturation of blood caused when breathing inadequate (hypoventilation), suspended (apnea), or when lungs unable sufficiently transfer gasses blood. such patients, may awake , alert, typically critically ill multisystem disease or multiple severe injuries. examples of such conditions include cervical spine injury, multiple rib fractures, severe pneumonia, acute respiratory distress syndrome (ards), or near-drowning. specifically, intubation considered if arterial partial pressure of oxygen (pao2) less 60 millimeters of mercury (mm hg) while breathing inspired o2 concentration (fio2) of 50% or greater. in patients elevated arterial carbon dioxide, arterial partial pressure of co2 (paco2) greater 45 mm hg in setting of acidemia prompt intubation, if series of measurements demonstrate worsening respiratory acidosis. regardless of laboratory values, these guidelines interpreted in clinical context.

airway obstruction

actual or impending airway obstruction common indication intubation of trachea. life-threatening airway obstruction may occur when foreign body becomes lodged in airway; common in infants , toddlers. severe blunt or penetrating injury face or neck may accompanied swelling , expanding hematoma, or injury larynx, trachea or bronchi. airway obstruction common in people have suffered smoke inhalation or burns within or near airway or epiglottitis. sustained generalized seizure activity , angioedema other common causes of life-threatening airway obstruction may require tracheal intubation secure airway.

manipulation of airway

diagnostic or therapeutic manipulation of airway (such bronchoscopy, laser therapy or stenting of bronchi) may intermittently interfere ability breathe; intubation may necessary in such situations.