# Damage to the Endotracheal Tube Caused by Incessant Biting by an Unconscious Patient After Stroke: A Case Report

## TL;DR

A patient's unconscious biting damaged an endotracheal tube after a stroke, highlighting a rare cause of ventilator issues.

## Contribution

Identifies unconscious patient biting as a novel cause of endotracheal tube damage in stroke patients.

## Key findings

- Unconscious patient biting caused ventilator tube leakage and compromised airway safety.
- This case highlights the need for mitigatory mechanisms to prevent ventilator circuit failure.
- Low Glasgow Coma Scale score indicates the need for airway protection, but new risks like tube biting exist.

## Abstract

Endotracheal intubation, a procedure performed using an endotracheal tube (ETT), has been identified as one of the most viable and common methods of managing the airway and artificially supporting respiration. Patient consciousness is an essential factor that is directly linked to airway safety, and an acute drop in the level of consciousness might threaten the airway. A Glasgow Coma Scale score of less than 9/15 is an indication of the need to protect the airway by conducting the commonly known procedure of endotracheal intubation. In the current case report, we found an unusual cause of leakage in the ventilator tube that affected the tube integrity: the involuntary tube biting of a patient admitted to the intensive care unit due to low consciousness provoked by an ischemic stroke. This constitutes an interesting phenomenon that must be investigated further. Aside from deciphering the underlying subconscious event, mitigatory mechanisms should be deployed along with ETT to prevent the ventilator circuit from failing.