An endotracheal tube (ETT) is used in anaesthesia, intensive care and emergency medicine for airway management and mechanical ventilation.

Procedure

It is inserted into the trachea, generally via the mouth, but sometimes through the nose (e.g. in extensive mouth surgery) or even through a tracheostoma. The process of inserting a ETT is called intubation.

Intubation usually requires general anaesthesia and muscle relaxation but can be achieved in the awake patient with local anaesthesia or in an emergency without any anaesthesia. It is usually performed by visualising the larynx by means of a hand-held laryngoscope but can also be performed "blind".

Endotracheal tubes are irritating and extremely uncomfortable to insert in a fully conscious, unanesthetised patient.

It is the most reliable available method for protecting a patient's airway.

Types

There are many types of ETTs. Endotracheal tubes range in size from 3-9 mm in internal diameter (ID) - different sizes are chosen based on the patient's body size with the smaller sizes being used for pediatric patients. Tubes larger than 6mm ID tend to have an inflatable cuff. Special double-lumen endotracheal tubes have been developed for lung and other intra-thoracic surgery. These tubes allow one-lung ventilation while the other lung can be collapsed to make surgery easier.