The Risks of Improper Intubation During Medical Treatment

MEDICAL - Intubation sounds frightening to most people, but it's truly a powerful tool that can protect a patient's life. A medical professional performs an intubation to support breathing when a person cannot breathe well enough on their own. When a patient is intubated, a flexible plastic tube, or endotracheal tube, is inserted through the mouth and into the windpipe, or trachea. Hospitals around the globe use this medical procedure every day; however, improper intubation can occur and comes with risks. This is what you need to know:

A Patient Is Intubated for These Reasons

You may be wondering why intubation is being performed in the first place, but there are several good reasons. This common medical procedure is generally safe, and statistics show that intubation in the United States alone is performed about 15 million times a year in operating rooms or other situations by healthcare professionals.

These conditions can lead to intubation:

1. A trauma or injury to your neck, chest or abdomen that would affect your airways
2. Fainting or a loss of consciousness, which could make you lose control of your airway
3. Respiratory failure, or the need for surgery that would make you unable to breathe on your own
4. An aspiration, where there's a risk of breathing in an object or substances, like food, blood or vomit
5. An airway obstruction, where something is blocking the flow of air
6. Cardiac arrest, or the sudden loss of heart function
7. Apnea, or a temporary stop in breathing

When Is the Tube Removed From the Patient?

The medical professional decides when it is safe to remove the intubation tube. This part of the procedure is an extubation and begins when the tape or strap holding the tube in place is removed. Then, a suction device removes any debris from your airway. The balloon inside your trachea will be deflated. After that step, you will be told to take a deep breath and then cough or exhale while they "pull out" the tracheal tube.

Most patients do not have major side effects after extubation and recover in a few hours or a week. Typically, your throat or pharynx will be sore for a few days. Some people have temporary trouble speaking because the vocal cords are still irritated, or the muscles you use to breathe and speak are weak following the "mechanical ventilation."

Intubation Requires Precision and Expertise

Unfortunately, errors can occur due to negligence from a healthcare provider. Intubation requires great accuracy and expertise; there's little room for mistakes in this type of medical procedure. When it hasn't been done properly, the consequences can range from temporary discomfort to a life-altering injury.

Complications for the patient can arise during these healthcare provider errors:

1. Esophageal intubation. This occurs when the breathing tube is incorrectly placed in the esophagus. The patient will experience poor ventilation/oxygenation with an increased risk of gastric complications.
2. Inadequate sedation. During intubation, paralysis can result in patient discomfort, resistance during the breathing tube insertion, psychological trauma and damage to the patient's airways, all stemming from inadequate sedation.
3. Inadequate monitoring. Monitoring of a patient's vital signs during and after intubation is extremely important and, when neglected, can result in delayed diagnosis of complications like heart problems, respiratory distress and hypoxia.
4. Mainstem bronchus intubation. When the breathing tube is placed into one of the mainstem bronchi instead of the trachea, the patient receives unequal ventilation and the risk of one lung becoming overinflated.
5. Tissue damage. Excessive force or improper technique during intubation can cause trauma or damage to a patient in several areas. These could include the teeth, gums, mouth, vocal cords, esophagus and other upper airway structures.
6. Stomach contents aspiration. This happens when gastric contents enter the trachea and lungs during intubation, usually if the patient vomits during the process. Aspiration significantly increases the risk of pneumonia and death.
7. Improper cuff inflation. When the endotracheal cuff has been over- or underinflated for the patient's needs, complications like poor ventilation, stiffening of the trachea, or even tissue death can occur. An overinflated cuff puts excessive pressure on the airway, blocking blood flow to those areas.
8. Delayed intubation. When a patient is not intubated quickly in an emergency where oxygenation is crucial, this failure can result in brain damage.
9. Equipment failure. Improperly monitored or uncalibrated intubation equipment can fail during a patient's procedure; this can result in poor oxygenation, brain damage, or even death.

Long-Term Complications From Intubation Errors

The patient can struggle following an intubation error that a medical professional performed in a variety of ways:

Voice changes. Voice pitch, quality, and range can be affected. This can impact communication and quality of life and may require speech therapy.

2. Dysphagia. A damaged esophagus during intubation can lead to dysphagia or difficulty swallowing. Eating and drinking become challenging, and this damage can also increase the risk of choking. In severe cases, the patient may not be physically able to get enough nutrition.

3. Ongoing breathing problems. The respiratory system can be damaged during intubation, leading the patient to ongoing breathing problems and reduced lung capacity. It can become a struggle for the patient to maintain a normal, active lifestyle.

4. Pulmonary fibrosis. Prolonged exposure to mechanical ventilation can cause pulmonary fibrosis (permanent scarring of lung tissue). This condition can compromise lung function and cause frequent coughing, labored breathing and exercise intolerance.

5. Post-traumatic stress disorder (PTSD). The patient can become traumatized following an intubation error, especially if too little sedation or pain medication was given. Some patients experience long-term anxiety, persistent nightmares and spontaneous trauma-evoked thoughts. Mental health support is crucial for these patients.

An intubation error can happen to you or someone you love. An experienced medical malpractice lawyer like the attorneys at McCoy & Hiestand, PLC can hold negligent medical providers accountable.

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