Why is ET medication administration generally considered a last resort?

ET medication administration is generally regarded as a last resort primarily because of the challenges associated with absorption and the need for higher doses. When medications are administered through the endotracheal (ET) tube, they bypass the normal digestive and metabolic pathways that would typically enhance their effectiveness and bioavailability. This route is known for variable absorption rates, which can result in inconsistent therapeutic effects. Consequently, higher doses are often necessary to achieve the desired clinical effect, increasing the risk of complications and side effects.

In acute medical situations, other routes of administration, such as intravenous (IV) or intraosseous (IO), are preferred whenever possible due to their reliable absorption and dosing accuracy. This makes ET medication administration less ideal and relegates it to scenarios where other routes are not feasible, such as when IV access cannot be established rapidly.