ABSTRACT
This chapter describes types of tubes usually used in intensive care unit, main complications of intubation and controversies surrounding endotracheal suction. To ventilate both lungs, endotracheal tubes (ETT) should end above the carina; this should be checked by auscultating for bilateral air entry, and ensuring chest movement is bilateral. Planned extubation should occur once: patients can adequately self-ventilate, and cough reflex is sufficient to maintain a clear airway management. Extubation stridor may be treated with: nebulised adrenaline, steroids, and Heliox. The Intensive Care Society recommends surgical tracheostomy with: difficult anatomy, proximity to site of surgery or trauma, potential instability, severe gas exchange problems, and children under 12 years of age. Intubation is often a necessary medical solution that creates various nursing problems. Oral ETTs cause discomfort and anxiety; nasal tubes and tracheostomies are usually tolerated better. Endotracheal suction is usually necessary to remove accumulated secretions, but can cause: distress, infection, trauma, hypoxia, and atelectasis.
