Patient education: Breathing tubes and ventilators (The Basics)

What is a breathing tube? — A breathing tube goes down the throat and into the lungs to help a person breathe. The medical term for when the doctors place a breathing tube in the throat is "intubation."

Some people need a breathing tube for a short time, like during surgery. Others might need a breathing tube for longer if they are very sick or hurt.

What is a ventilator? — A ventilator is a machine that helps a person breathe. It connects to a breathing tube. The machine can do some or all of the breathing work. The medical term for when a person is connected to a ventilator is "mechanical ventilation."

A ventilator does not fix the disease or problem that makes it hard to breathe. But it might keep a person alive until the problem is fixed or until they can breathe again on their own.

Why do I need a breathing tube and ventilator? — You might need a breathing tube and ventilator to:

●Help you breathe easier until you can breathe on your own

●Help you get more oxygen into your body and carbon dioxide out of your body

●Give you breathing help quickly in an emergency

●Help with breathing during surgery or after an injury

●Breathe for you if you have a brain or spinal cord injury

●Open your airway, or remove blockages from your airway

●Protect your lungs from stomach fluids

What happens before a breathing tube is placed? — Before placing a breathing tube, your doctor will do an exam and review your history. They might also review your lab tests and X-rays, if available. In some cases, doctors need to place a breathing tube in an emergency.

If it is not an emergency, the doctors will talk with you about your options. They will discuss the risks and benefits of having a breathing tube. Ask the doctor or nurse if you have questions or if there is anything you do not understand.

If you are going to have surgery, the doctor or nurse will tell you if you need to do anything special to prepare. They might ask you to stop eating and drinking for a short time. You might need to remove your dentures if you have them.

What happens during intubation? — Most of the time, the doctor will put a breathing tube through your mouth and into your throat.

When it is time for the procedure:

●The doctors will give you a medicine to make you sleepy. They might also give you other medicines to numb your throat or help your muscles relax when the tube is put in.

●The doctor will put an oxygen mask on your face to give you extra oxygen.

●The doctor will gently tilt your head back. This makes it easier to put in the breathing tube.

●The doctor will use a special tool called a "laryngoscope" to move your tongue so they can see your vocal cords (voice box). The laryngoscope looks like a tongue depressor that is connected to a handle. There is a light on the end that lets the doctor see your vocal cords. They will gently place 1 end of the breathing tube between your vocal cords and into your windpipe.

●The doctor will remove the tool and secure the tube in place. Many breathing tubes have a small balloon at the end of the tube. The doctor will put a small amount of air in the balloon to help the tube stay in place. This also keeps the air from coming out around the tube. They will use tape or a special holder to hold the breathing tube in place.

●The breathing tube will be connected to the ventilator to help you breathe.

●Most of the time, this procedure takes only a minute or 2.

What happens after the breathing tube is placed? — After the breathing tube is in place, the staff will connect it to a ventilator. The doctor will adjust the ventilator settings to make sure that you have the right amount of oxygen and carbon dioxide in your blood.

If you only need a breathing tube for surgery, the doctor will take it out when the surgery is finished. They will make sure that you are awake and able to breathe on your own.

You might need a breathing tube for a longer time. For example, this might be the case if you have very bad pneumonia and are in the intensive care unit ("ICU"). If so:

●The staff might do blood tests to check the levels of oxygen and carbon dioxide in your blood.

●You might have some discomfort from the tube, if you are awake. But you will get medicines to keep you relaxed and comfortable while the breathing tube is in place.

●Sometimes, a person needs to have a restraint on their hand while they have a breathing tube in place. This helps to keep them from pulling on the tube or other equipment by accident.

●You will not be able to eat, drink, or talk until the breathing tube is removed.

When will the breathing tube be removed? — This depends on why the tube was placed. Some people only need a breathing tube during surgery. Others need a breathing tube for a few hours, a few days, or much longer.

As you recover, the doctor will adjust the ventilator settings, so you are doing more of the work of breathing on your own. When you are healthy enough to fully breathe on your own, the doctor will take out the breathing tube.

What are the risks of having a breathing tube and being on a ventilator? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks of having a breathing tube placed include:

●Low blood pressure

●Injury to your teeth, lips, tongue, or vocal cords

●The tube being in the wrong place

Possible risks of needing a breathing tube and ventilator for a longer time include:

●Infection

●Injury to your lungs, windpipe, or vocal cords

●Being unable to breathe well enough on your own and continuing to need a ventilator

●Bleeding in your stomach

You might have a sore throat for a short time after the breathing tube is removed. You might also have trouble swallowing or talking when the tube has been in place for a few days or more. But this generally gets better over time.

More on this topic

Patient education: Questions to ask if you are having surgery or a procedure (The Basics)
Patient education: Medical care during advanced illness (The Basics)