Thumbnail image of: Respiratory System: Illustration
Thumbnail image of: Tracheostomy Tube: Illustration

Respiratory Intubation, Surgical

What is respiratory intubation and mechanical ventilation?

Respiratory intubation means a tube is put into your windpipe (trachea) to protect your airway and help you breathe. A tracheostomy is surgery to make a small opening through the front of your neck and into your windpipe (trachea). A tube is then placed through the opening and into your windpipe. The tube keeps your airway open and helps you breathe by allowing air to flow into and out of your lungs. It may be attached to a breathing machine, called a ventilator, which breathes for you by moving air into and out of your lungs. This is called mechanical ventilation.

The terms tracheostomy, tracheotomy, and trach may be used to refer to both the surgical procedure and to the opening created by the procedure.

A tracheostomy may be done when you have a problem with your airway. For example, it may be done if:

  • You have an injury or a condition that makes it hard to breathe, cough up the mucus in your airways, or swallow.
  • You will be on a ventilator for a long time.

A tracheostomy may be done as an emergency or as a planned procedure. It may be temporary or you may have it for life.

How is respiratory intubation and mechanical ventilation done?

Before the procedure:

  • Your healthcare provider will ask you to sign a consent form for respiratory intubation if it is not an emergency. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
  • Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
  • Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or illegal drugs.
  • You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.

During the procedure:

  • You will be given a sedative through your IV to help you to relax.
  • You will be given medicines to prevent pain during the procedure. These may include:
    • Local anesthesia, which numbs the area where the tube will be placed
    • General anesthesia, which relaxes your muscles and you will be asleep.
  • The surgeon will make a cut in the front of your neck and into the trachea. Your provider will then put a tube into your trachea and secure it in place.
  • Your provider may connect your breathing tube to a ventilator. If necessary, a ventilator will deliver oxygen into your lungs a set number of times per minute.
  • If you are on a ventilator, the tube will have a balloon around it to prevent air from leaking. In this case you will not be able to talk.
  • If you do not need a ventilator, a smaller tube may be used that allows air to pass around it. In this case you may be able to talk.
  • Your heart rate and oxygen level will be monitored during the procedure.

After the procedure:

  • You will be checked often by nursing staff.
  • You will have blood tests to check the amount of oxygen and carbon dioxide in your blood.
  • Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
  • There will be a dressing on your neck around the site where the tube was inserted. The dressing will be checked and changed by your provider or the nursing staff as needed.
  • Your provider may prescribe medicine to:
    • Treat pain
    • Help you relax or keep you from moving around too much and pulling the tube out
    • Help relax your airways
    • Reduce swelling in the airways
  • If a ventilator is helping you breathe, the settings may gradually be changed to allow you to do most of the work of breathing, with support from the ventilator as needed.
  • The tracheostomy site will begin to heal and your surgeon will monitor you for a few days. The original tube is usually kept in place for 5 to 10 days. After that a new tube may be used.
  • A tracheostomy may be temporary or permanent. If you no longer need it, your surgeon will remove the tube and allow the opening to close on its own. If it does not close in 4 to 6 months, it may be closed with surgery.

What can I do to help?

  • You or your family will need to tell your healthcare team if you have new or worsening:
    • Anxiety
    • Chest pain
    • Trouble breathing or feeling like you are not getting enough air
    • Increased pain at the tracheostomy site
  • Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors, such as why you need a tracheostomy and the severity of your condition.

Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth.
Last modified: 2014-11-07
Last reviewed: 2014-07-31
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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