How to avoid airway injury and bleeding that may be caused by tracheal tube?

In order to avoid possible tracheal tube and bleeding during endotracheal intubation, it is important to first pay attention to adequate preparation and accurate operation skills. Before the operation, the doctor should carefully evaluate the patient's airway condition, including checking the shape of the airway, whether there is swelling, mucosal damage, abnormal anatomical structure or other potential airway problems. For patients with narrow, swollen or easily bleeding airways, special intubation strategies may be required to select appropriate equipment and intubation methods. Avoiding forced intubation when the airway is unstable or swollen can effectively reduce damage.
During the intubation process, the doctor should ensure that the procedure is as gentle as possible and reduce excessive force. In particular, avoid using excessive force when the intubation tube passes through the larynx and trachea. Excessive pressure or improper force may cause damage to the airway and even cause bleeding on the inner wall of the airway, especially when the tube passes through the glottis. Through proper operation skills, ensure that the tube enters the airway smoothly and avoids severe friction or compression. Any foreign matter, mucus or secretions in the airway should also be removed as much as possible before intubation to prevent airway bleeding due to friction during intubation.
It is crucial to choose the right tube size for intubation. Too large or too small tubes will increase the chance of tracheal tube. If the tube is too large, it may cause excessive expansion of the airway and prolonged pressure on the inner wall of the airway, which may cause injury or bleeding; if the tube is too small, it may not provide adequate ventilation and increase friction and difficulty during intubation, thereby increasing the risk of injury. Therefore, choosing the appropriate size of the endotracheal tube according to factors such as the patient's body shape, airway characteristics and age can significantly reduce the risk of tracheal tube and bleeding during intubation.
During endotracheal intubation, care should also be taken to avoid excessive stimulation of the airway mucosa as much as possible. For patients who already have airway inflammation, swelling or trauma, special care should be taken during intubation. Postoperative airway care is particularly important. Sputum should be suctioned regularly to keep the airway open and avoid accumulation of sputum, blood or other secretions in the airway. Cleaning the airway and ensuring moderate pressure in the airway can help reduce tracheal tube and avoid bleeding.
After intubation, the patient's airway status should be continuously monitored. Confirm the position of the endotracheal tube through imaging examinations (such as X-rays, CT scans, etc.) to ensure that it is in the correct position. If symptoms such as airway discomfort, bleeding, and swelling occur after intubation, immediate intervention measures should be taken to prevent the situation from deteriorating further. Post-intubation care should include inspection and maintenance of the airway, such as keeping the airway moist, maintaining appropriate respiratory pressure, and regular airway flushing.