Advantages and disadvantages
Tracheal intubation is considered to be the safest method to ensure
the airway and to achieve mechanical ventilation in the case of a patient in
cardiorespiratory arrest, as well as in other situations that require
ventilatory support.
Advantages
- Protects the airways against aspiration
- Facilitates ventilation and oxygenation
- Allows aspiration of secretions from the lower airways
- Provides a route of administration of cardiopulmonary resuscitation drugs
- Prevents gastric distension due to ventilation
- Protects the airways against edema and compression
Disadvantages
- Requires special training and experience
- Can aggravate pre-existing air obstruction (eg epiglottitis)
- Can cause local damage (teeth, tongue, soft and hard palate)
- Potential exacerbation of a cervical spine injury
- Orotracheal intubation is preferable in: apneic patients, mid-facial fractures, patients with known coagulopathy
- Nasotracheal intubation is performed in: patients with preserved spontaneous breathing, patients with a short and thick neck
- Any of the techniques can be used in patients with suspected cervical spine injury provided the neck is immobilized
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