Intubation
The placement of an endotracheal tube (ETT) into the trachea to maintain an open airway and facilitate mechanical ventilation.
The exam loves the just-intubated scenario: the most reliable confirmation of tracheal placement is continuous waveform capnography detecting sustained exhaled CO2 — pick that over auscultation when both appear, because breath sounds can mislead (an esophageal tube may seem to “blow air,” and a brief CO2 reading can fade within a few breaths). The classic trap is the tube that slips too deep: right mainstem intubation presents with breath sounds and chest rise on the right only, and the fix is to withdraw the tube until left-sided sounds return, not advance it. After confirmation, priorities shift to preventing unplanned extubation and ventilator-associated pneumonia — keep the head of bed at 30–45 degrees.
Don’t confuse the related skills. Suction is the response to secretions in an established airway (sterile, each pass ≤10–15 seconds, hyperoxygenate first, no routine saline); intubation establishes the airway. Telemetry/monitoring watch rhythm and labs but never confirm tube position. Memory hook for sudden vent deterioration: DOPE — Displacement, Obstruction, Pneumothorax, Equipment failure.
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