What is an endotracheal tube?
The endotracheal tube (ET) is used for ventilation. It is a flexible plastic hose that through the high pitch directly into the trachea is introduced. This process is also called endotracheal intubation. You connect the end of the tube to a ventilation device through which oxygen is passed on to the lungs. The great advantage of this method: the endotracheal tube keeps the airways open, even if the patient vomits. That makes it a very safe method to keep the airways free.
However, endotracheal intubation is compared to other methods (e.g.Wendl Tubus orGüdel Tubus) very difficult to implement. It should therefore only be used by trained anesthesia and internists.
Find the right tube size for your patient
There are endotracheal tubes in different sizes. The size of the pipe is specified based on the inside diameter. This can be between 2 mm and 10 mm lay. For children you should only use thin tubes, larger tubes are used in adults. The diameter of the patient's small finger is used for orientation: the ET hose should never be thicker.
Components of the endotracheal tube:
- Bivel: This is the beveled tip of the ET hose. It makes easy access to the trachea possible.
- Murphy’s Eye: This additional opening at the top of the hose supports the ventilation or gas exchange.
- Cuff: The tube can be placed with or without the so called "cuff". The cuff is inflated via a thin hose and seals the trachea. This reduces the risk of aspiration. In children under the age of six, it is often avoided because their trachea is more susceptible to damage on the one hand, and on the other hand the mucous membrane is already better sealed.
How is the endotracheal tube placed?
Important: only for this purpose trained specialist staff should carry out the endotracheal intubation.
- With 100 % oxygen, the patient is pre oxygenated for about five minutes to give the doctor more time to intubate.
- Through aLaryngoscope the tongue is kept out of the way while the hose is inserted into the trachea.
If the patient is conscious, you should relieve his fears during the placement and removal of the tube using medication.
When is an endotracheal tube used?
- With general anesthesia: The muscles including diaphragm are paralyzed with general anesthesia, so the patient must be ventilated via an endotracheal tube.
- For foreign bodies in the airways: It makes it easier to remove the foreign bodies from the trachea.
- To protect the respiratory tract from aspiration: The tube, for example, is avoided with massive gastrointestinal bleeding or in the event of a stroke that stomach contents get into the airways.
- After operations on the chest: According to cardiac or lung surgeries, the hose can remain in the body to facilitate breathing.
- To support breathing: In the event of breathing difficulties due to pulmonary inflammation, lung collapse, in the event of impending breathing failure, heart failure or unconsciousness due to an overdose, a stroke or a brain injury.
- To sedation: To administer anesthesia gases during the operation
For emergencies "on the street", this form of intubation should only be used in exceptions. If the endotracheal tube is put incorrectly, this can lead to the patient's death.
What do you have to pay attention to when buying an endotracheal tube?
- Pay attention to the size: You should always have tubes in several sizes and use the right size. The wrong size can lead to injuries to the trachea or ineffective ventilation.
- With cuff or without: When buying the tube, take into account whether a cuff is contained or not.
- Sterile packaging: For hygienic reasons, each tube should be packed individually sterile.
- Latex free: To avoid any allergic reactions, you should only use latex free hoses.
What is the difference between Güdel, Wendl, Endotracheal and Larynx tube?
Endotracheal tube: You use this tube for invasive ventilation. Since it is inserted into the trachea via the creeper, the risk of aspiration is low. However, it is difficult to apply and should therefore only be used by experienced anesthetists and internists.
Güdel Tubus: It is inserted through the mouth and prevents the tongue from slipping backwards and thereby letting the airways lay. It is used for ventilation of unconcerned patients to facilitate ventilation.
Wendl Tubus: In contrast to theGüdel Tubus inserted over the nose. As a result, it can also be used in awakening patients in which oneGüdel Tubus would trigger a gag reflex. You can do theWendl Tubus Also use when patients squeeze their pine together.
Larynxtubus: This is an alternative airway. It is used if intubation does not succeed or the user has little practice with inserting an endotracheal tube. The application of thelarynx tube is comparatively simple and associated with low risk. It is used in both OPS and preclinical emergencies.
Suitable accessories
Video: It is used for airway protection and tracheal intubation. The device is used to have an optimal view of the larynx.
Ventilation mask: TheVentilation mask Can with a ventilator, circle orVentilation bag be combined. Thanks to the elastic edge, an airtight cover on the face is possible.
Ventilation bag: Become for manual ventilationVentilation bag used. They are ideal for emergency doctors and rescue workers and are used as a backup in the operation if thatVentilator fail.
Ventilation devices: The mechanical ventilation withVentilation devices is a safe alternative toVentilation bag. It enables comprehensive monitoring and several ventilation modes.
Oxygen bottle: With us you will findOxygen bottles In different sizes - handy bottles for the emergency bag as well as large oxygen bottles for hospitals or care facilities.