An intubation injury is caused by problems with the insertion of a tube to clear the airway or with prolonged intubation, usually in an intensive care setting. It can also occur in surgery, where intubation is used to control the airway and deliver anesthesia. Injuries can include soft tissue damage, perforations, and infections in the mouth and airway. In cases where a patient has what appears to be an intubation injury, a doctor needs to perform a careful evaluation to confirm and determine the best course of treatment.
During intubation procedures, care providers carefully insert a tube into the trachea to access the airway, going through the mouth or nose. This can create soft tissue damage as a result of pushing too hard, using the wrong tube size, or approaching from the wrong angle. If the tube ends up in the esophagus, this can create injuries, and it can also cause problems if it is advanced too far into the airway.
Other problems during insertion can involve damage to the structures in the mouth, including the teeth and jaw. These could be chipped, bruised, or displaced if people don’t use intubation equipment properly. Vocal cord paralysis and injuries deep in the airway can also occur during the intubation process. Medical providers with more experience are less likely to cause an intubation injury, but sometimes a patient has unusual anatomy or the circumstances are less than ideal, and there is a risk of damage.
The longer the tube remains in place, the greater the risk of an intubation injury. One concern is the development of an infection, because the systems naturally at work to prevent infection may be suppressed. This can cause serious complications, including the formation of cysts in the airways. The patient’s vocal cords and other structures can also be damaged by prolonged pressure, which may make it difficult to speak or swallow after the tube is removed.
Medical providers who may need to perform intubation in the course of their work receive extensive training in correct technique, along with practice under supervision. They discuss common risks and ways to prevent them in order to provide the best possible care to their patients. Individual medical facilities may have additional protocols people are asked to use during the initial insertion procedure to decrease the risk of injury, along with guidelines to prevent intubation injury when patients need to be intubated for extended periods of time.