How To Insert a Breathing Tube

A breathing tube, also called an endotracheal tube, is inserted into a person's airway in a procedure referred to as intubation. A patient will need to be intubated before being placed on a mechanical ventilator to assist with breathing or to maintain an open airway. Although a breathing tube can be inserted through the nose, according to the National Institute of Health, it most often is inserted through the mouth. Proper procedure to insert a breathing tube is essential to provide adequate ventilation to the patient.

Things You'll Need

  • Laryngoscope
  • Stylet
  • 10 millimeter syringe
  • Tape
  • Endotracheal tube


    • 1

      Check the equipment to determine if it's functioning correctly. Extend the laryngoscope handle and ensure the light bulb works. Attach a 10 millimeter syringe to the cuff on the endotracheal tube, and pull back on the plunger and than push the plunger back in to be sure the cuff inflates; deflate the cuff prior to intubation.

    • 2

      Put a stylet into the endotracheal tube. The stylet helps the tube become more rigid for insertion.

    • 3

      Position the patient's head into the sniffing position. Lift up on the chin while pushing slightly down on the forehead to help open the airway.

    • 4

      Use a bag-mask ventilation device to give oxygen prior to intubation. Place the mask over the patient's mouth and nose, hold firmly and squeeze the bag for eight breaths.

    • 5

      Place the laryngoscope into the patient's mouth above the tongue and lift straight up to view the larynx. Once the larynx is spotted, look for the vocal cords.

    • 6

      Insert the endotracheal tube through the mouth and in through the vocal cords. According the University of Virginia Health System, the tube should be inserted about one centimeter past the vocal cords.

    • 7

      Take the sylet out of the tube and remove the laryngoscope from the patient's mouth. Attach the syringe to the cuff on the tube and inflate it with about eight millimeters of air. Secure the tube with tape.

Tips & Warnings

  • Confirm proper tube placement with a chest x-ray. Watch the chest for rise and fall and listen for equal breath sounds on both sides. An end-tidal carbon dioxide detector can also be placed on the end of an endotracheal tube to detect exhaled carbon dioxide.
  • Possible complications which can occur when inserting a breathing tube include bleeding and damage to the vocal cord or trachea.
  • Avoid putting any force on the teeth during insertion of the breathing tube. This could fracture the teeth.
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