Endotracheal Tubes

An endotracheal tube (also called an ET tube or ETT) is used in general anaesthesia, intensive care and emergency medicine for airway management, mechanical ventilation and as an alternative route for many drugs if an IV line cannot be established. The tube is inserted into a patient’s trachea in order to ensure that the airway is not closed off and that air is able to reach the lungs. The endotracheal tube is regarded as the most reliable available method for protecting a patient’s oxygen mask .

Types of tracheal tube

Types of endotracheal tube (ETT) include oral or nasal, cuffed or un-cuffed, preformed (e.g. RAE tube), laryngeal mask airway, double-lumen tubes and tracheostomy tubes. For human use, tubes range in size from 2-10.5 mm in internal diameter (ID). The size is chosen based on the patient’s body size, with the smaller sizes being used for paediatric and neonatal patients. Tubes larger than 6 mm ID usually have an inflatable cuff.

Endotracheal tube

Originally made from red rubber, most modern tubes are made from polyvinyl chloride. Those placed in a laser field may be flexometallic.

Dr. Robertshaw (and others) developed double-lumen endo-bronchial tubes for intra-thoracic surgery. These allow single-lung ventilation whilst the other lung is collapsed to make surgery easier. The deflated lung is re-inflated as surgery finishes to check for fistulas (tears).

Another type of endotracheal tube has a small second lumen opening above the inflatable cuff, which can be used for suction of the nasopharngeal area and above the cuff to aid extubation (removal). This allows suctioning of secretions which sit above the cuff which helps reduce the risk of chest infections in long-term intubated patients.

A shortened tube, a tracheostomy tube, can be inserted through an opening in the neck (a tracheostomy) into the trachea. This is often a temporary stoma, but patients can live with them permanently.

Originally published here.