Endotracheal Tube - An Important Medical Device Used in Critical Care
Endotracheal tubes, also known as ETTs, are flexible plastic tubes that are inserted through the mouth or nose and then threaded into the trachea (windpipe) to establish and maintain an airway during surgery or during a medical emergency. ETTs allow healthcare providers to control a patient's breathing by delivering oxygen or other gases directly into the lungs and removing carbon dioxide. They also help protect the lungs from stomach acid and prevent food or liquid from entering the lungs which could cause pneumonia.
Components and Design of Endotracheal Tubes
All Endotracheal Tube consist of several key components. The distal tip is the end that is inserted first into the trachea. It is usually soft and malleable so it can flex and easily navigate the curves of the trachea without damaging the delicate tissues. The proximal end stays outside of the patient and connects to mechanical ventilation equipment like a ventilator or breathing bag. In between is the main shaft of the tube which is usually semi-rigid plastic such as polyvinyl chloride (PVC). The internal diameter ranges from size 3.0-9.0 mm depending on the patient's age and size. Most tubes have an inflatable cuff or balloon near the distal tip which is filled with air to form a seal in the trachea once in place. Other optional components include tube connectors, bite blocks, inflatable cuffs, subglottic suction ports, and cuff pressure manometers.
Indications for Endotracheal Intubation
There are several medical conditions and procedures where endotracheal intubation is necessary including:
- Respiratory failure or respiratory arrest - ETTs allow mechanical ventilation support when a patient is unable to breathe effectively on their own due to conditions like asthma attacks, drug overdoses, drowning, smoke inhalation injuries, etc.
- Airway obstruction - Foreign bodies, severe infections, burns or trauma that are blocking the airway require intubation to open and protect the airway.
- General anesthesia - Most complex surgeries require general anesthesia which depresses the respiratory drive. Intubation is done to protect and control ventilation during these procedures.
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