Tracheal intubation

Tracheal intubation is the placement of a tube into the trachea. It provides the gold standard for airway protection ensuring the trachea and lungs are protected from the aspiration of stomach contents. The tube can be used for ventilation permitting oxygen delivery and the removal of carbon dioxide; it also has a role in delivering drugs. If the tracheal tube is misplaced and not recognized, then hypoxia will occur which may be fatal. Tracheal intubation was first recorded in 1543, but few advances were made until the First World War when its importance was recognized. Sir Ivan Whiteside Magill was predominantly involved in the development of tracheal intubation and he designed several pieces of equipment we still use in our clinical practice today. Prior to intubation the required equipment should be assembled and checked and the indication for tracheal intubation confirmed. An experienced and trained assistant is required and an anaesthetist with advanced airway skills should be available. Following tracheal intubation, correct placement of the tube should be confirmed by clinical signs and capnography. The tube should be carefully secured to avoid displacement.