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Intubation is a common procedure used with general anesthesia. New guidelines aim to reduce the incidence of esophageal intubation, which occurs when the esophagus is mistaken for the trachea during intubation.

The COVID-19 pandemic introduced the term “intubation” into everyday conversation but many people do not know how the procedure works.

If you have undergone a procedure with a general anesthetic, it is likely you have experienced intubation.  A patient is usually not conscious when the tube is inserted into the mouth or nose, nor are they awake when it is removed. The tube is inserted past the vocal cords to the area where the trachea branches out to the lungs. Because general anesthesia alters breathing, the tube ensures the airway stays clear, delivers oxygen and protects your lungs from aspirating the contents of your stomach during surgery.

Esophageal intubation is a dangerous complication of intubation that occurs when an anesthesiologist or certified registered nurse anesthetist (CRNA) mistakenly inserts the breathing tube into the esophagus (food tube) instead of the trachea—what we commonly call the “windpipe.” One estimate suggests esophageal intubation occurs in five of every 100 intubations.  When the tube is incorrectly placed, the patient is no longer receiving oxygen, quickly starving the brain and causing permanent brain damage and sometimes death.

In 2019, 54-year-old California woman Maria Sauceda presented for surgery to remove a lump in her breast. The anesthesiologist mistakenly performed an esophageal intubation without recognizing the mistake.  Ms. Sauceda suffered irreversible hypoxic brain injury and now lives permanently in a nursing facility with 24-hour nursing care.  In April of this year, the hospital settled with the family of Ms. Sauceda for $12 million.

Recognizing the danger and too-common frequency of this deadly anesthesia complication, several groups collaborated on guidelines to reduce esophageal intubation.  Said the authors, “Current evidence shows that unrecognised oesophageal intubation occurs sufficiently frequently to be a major concern and to merit a coordinated approach to address it.”  The new guidelines, published in the journal Anaesthesia, provide recommendations for placing and monitoring the airway.  The authors stress the importance of exhaled carbon dioxide monitoring to ensure the airway is not blocked and the patient is breathing throughout the procedure.

Safe airway management is the job of the anesthesiologist and other staff who are employed to ensure a patient is properly ventilated and oxygenated during a procedure. If your loved one is seriously injured through an esophageal intubation or other medical malpractice, reach out to our legal team for assistance.

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