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In a nasotracheal procedure, an endotracheal tube is passed through the nose and vocal apparatus into the trachea. Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated.
The tube may be difficult to position, particularly in an unwell patient, and may inadvertently be inserted in the trachea, hence endotracheal intubation before the procedure is strongly advised to secure the airway. The tube is often kept in the refrigerator in the hospital's emergency department, intensive care unit and gastroenterology ward.
Another important contribution by Macewen to modern surgery was the technique of endotracheal anaesthesia with the help of orotracheal intubation, which he described in 1880, and still in use today. Macewen was noted for his early and creative use of photographs for documenting patients' cases and for teaching surgery and medicine.
Other tubes (such as the Bivona Fome-Cuf tube) are designed specifically for use in laser surgery in and around the airway. Various types of double-lumen endotracheal (actually, endobronchial) tubes have been developed (Carlens, [ 6 ] White, Robertshaw, etc.) for ventilating each lung independently—this is useful during pulmonary and other ...
Intubation (sometimes entubation) is a medical procedure involving the insertion of a tube into the body. Patients are generally anesthetized beforehand. Examples include tracheal intubation , and the balloon tamponade with a Sengstaken–Blakemore tube (a tube into the gastrointestinal tract ).
Endotracheal intubation carries with it many risks, particularly when paralytics are used, as maintenance of the airway becomes a challenge if intubation fails. It should therefore be attempted by experienced personnel, only when less invasive methods fail or when it is deemed necessary for safe transport of the patient, to reduce risk of ...
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After apnea created by RSI the same high flow nasal cannula will help maintain oxygen saturation during efforts securing the tube (oral intubation). [31] [32] The use of nasal oxygen during pre-oxygenation and continued during apnea can prevent hypoxia before and during intubation, even in extreme clinical cases. [33]