Intubation and Mechanical Ventilation in the ICU
at the American Family Children’s Hospital
Intubation is the process used to place a
breathing tube or ET (endotracheal) tube
through a patient’s mouth or nose into their
windpipe. Breathing tubes are used during
surgery and whenever your child needs help
A ventilator is the machine used to help your
child breathe with less effort until he or she
is able to breathe on his or her own. This
machine is also called a vent or breathing
machine. Your child is connected to the
ventilator through an ET tube. Our aim is to
help children heal quickly and get them off
the ventilator as soon as we can.
The ventilator is used to:
ξ Make it easier for the patient to
ξ Get air into the body.
ξ Get carbon dioxide out of the body.
Children with severe breathing problems
(respiratory failure) may have low levels of
oxygen and high levels of carbon dioxide
even though they are getting extra oxygen.
Others have normal levels, but find it very
hard to breathe. Severe injury can also get in
the way of good breathing. In all of these
cases, a ventilator is needed since your
child’s lungs are no longer doing these jobs
well. Keep in mind, a ventilator does not fix
disease. It helps to keep your child alive
while treating serious conditions.
Risks of Intubation
As with any procedure, there are risks. A
Ventilator Associated Event (VAE) is a
condition that may occur in a person who is
on a ventilator. VAEs include:
ξ Infection – Having a tube in the
windpipe can make it easy for bacteria
to get into the lungs, potentially leading
to pneumonia. This problem is often
treated with antibiotics.
ξ Collapsed lung (pneumothorax) –
The ventilator pushes air into the lungs.
There is the risk that the lung could be
over-expanded. Tiny sacs in the lung
can then leak air into the chest causing
the lung to collapse. If this occurs, the
doctors may insert a chest tube into the
chest wall to drain the leaked air. This
allows the lung to re-inflate.
ξ Lung damage –The extra pressure
from the machine can damage
immature or diseased lungs or lungs
that are not working well.
ξ Unplanned removal of the breathing
tube – Despite best efforts to keep the
tube safe and secure, the tube may
become dislodged before the doctors
intend to remove it under controlled
conditions. This may be a result of any
number of problems, including
coughing or loss of the adhesive on the
tape that keeps the tube in place.
Often, the tube will need to be replaced
Keeping your child safe while on a
Your child’s safety is a top priority. We
do several things to help reduce the
chance of VAE:
ξ We keep the head of the bed raised
between 30° to 45° degrees unless
other medical conditions do not
ξ We suction when needed. It is
normal for saliva to collect inside the
mouth and inside the breathing tube.
As this fluid collects, it can grow
bacteria and may cause VAE. We
remove this fluid from the mouth and
breathing tube when needed.
ξ We brush your child’s teeth and
gums and clean the inside of his or
her mouth a few times each day. Oral
care can decrease the amount of
bacteria in the mouth and on the
teeth while your child is on the
ξ We give medications to help keep
your child calm and comfortable, but
still stay awake as much as possible.
This is so your child is calm and
comfortable enough to keep the tube
in the correct position, but also so he
or she can be taken off the ventilator
as soon as possible. Sedatives may
be given to your child to keep him or
her drowsy. If these drugs start to
build up in the body, the patient
could remain in a deep sleep or
drowsy for hours to days, even after
the drugs have been stopped.
ξ We clean our hands with soap and
water or alcohol-based hand rub
before and after touching the patient
or the ventilator.
ξ We take great care in moving our
patients and shifting their position in
their bed/crib to avoid unintentional
dislodgment of the tube.
Things You Can Do to Help Your Child
ξ Let your child’s nurse know if your
child is agitated, is crying, is moving
around in bed, or seems
ξ Notify your child’s nurse if you are
worried that the ET tube placement
looks loose or not secure.
ξ Ask your child’s nurse to help you
before moving your child or starting
ξ Please clean your hands before
entering your child’s room and when
you leave the room. Antiseptic gel
dispensers are located in each patient
room and in the hallway.
ξ Try to keep noise volumes and
stimulation in your child’s room low.
Giving your child plenty of time to
rest may help them heal and grow.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 1/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF #7954.