Endotracheal intubation is performed in the setting of respiratory failure due to any cause, including respiratory failure from asthma. It is a potentially life-saving medical intervention. Patients who require endotracheal intubation are critically ill, because their lungs are unable to take in oxygen and exhale carbon dioxide. The intubation procedure itself can be performed in an emergency room, an intensive care unit, or out of hospital, in the field, provided the appropriate equipment and qualified medical personnel are available. Ambulance crews with advanced cardiac live support (ACLS) certification are trained in endotracheal intubation. The procedure itself consists of the temporary placement of a soft, flexible, plastic breathing tube through the nose or mouth, past the voice box (larynx), and into the trachea or main breathing tube.
Endotracheal intubation serves three major functions. First, it keeps a person’s airway open in situations when it would otherwise close off, causing asphyxiation, such as in the case of decreasing levels of consciousness. Second, it also allows for the removal, by suctioning, of any mucus that has accumulated in the airways. Third, and perhaps most importantly, endotracheal intubation allows a doc-tor to provide the intubated patient with breaths and extra oxygen to inhale, thus taking over the work of breathing from failing lungs.
In order to take over a per-son’s breathing, the end of the endotracheal tube is connected to a ventilator. A ventilator is a machine that is designed to provide individualized support to a patient in respiratory failure. The support provided by the ventilator consists of breaths along with supplemental oxygen. Once ventilator support is initiated, then the focus shifts to treatment of the underlying cause of the respiratory failure. The goal is to reverse the process that led to a need for intubation. If lung function thus returns and there is no longer a need to assist breathing, then the endotracheal tube is easily removed.