From what i understand youd gag on it. Are there circumstances where its needed – eg youre awake but airway is closing – and if so what would be done instead
In: Biology
They pretty much just slide it into your airway. Usually a nurse/medic will dive on top of you if you’re trying to take it out. They will also basically tie up your hands so you can’t. Only in extreme emergencies, and they sedate you asap
Drugs are wonderful things. Just as with anesthesia for surgery, we medicate you into oblivion and slide a tube into your airway.
But when we are trying to get someone OFF a breathing machine (ventilator) we often do wake them up and greatly lessen or stop their sedation to see if they are breathing sufficiently. That can be hell, but some people are able to zen their way thru it.
Awake intubation. Numbing spray in the back of your throat, flexible intubation scope (to see what the airway looks like) and sedation. It’s not fun for the patient or the anesthesiologist (or the circulating RN) but it sometimes the safest way to go to sleep for surgery.
In the emergency setting, we give a paralytic like succs or roc, and a sedative like ketamine or etomidate. Then we can intubate, after the intubation we give post sedation and pain meds to keep the PT sedated, and a long term paralytic if needed.
This is my protocol. The meds vary but the idea is the same. Paralysis and sedative, make sure they don’t regain consciousness while tubed. Being paralyzed, tube and conscious sounds like a nightmare
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