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Endotracheal tube malposition

Cunningham PJC - MedPix (2001)

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Affiliation: Madigan Army Medical Center

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Complications of endotracheal intubation include acute laryngotracheal injury, tooth avulsion, laryngospasm, sinusitis, pneumothorax, edema of the vocal cords and glottis, pharyngeal injury, tracheal ulcers, epistaxis, aspiration of gastric contents, cardiac arrest, seizures, anoxic brain damage, and malpositioning of the endotracheal tube, including esophageal intubation... Accidental intubation of a mainstem bronchus will lead to absent breath sounds on the contralateral side with worsening atelectasis, tracheal deviation to the contralateral side, and hyperinflation of the intubated lung... Hypoventilation and hypoxemia may result... A chest radiograph will verify the position of the tube and help to exclude a pneumothorax... In a recent study involving intubated ICU patients, of 246 patients, radiographs demonstrated that 185 of the patients had malpositioned endotracheal tubes... In 107 patients the tube was at or above the level of the clavicles, while in an additional 78 the distal end of the tube was within 2 cm of the carina... Patient movement can account for many of these cases, as head extension can raise the tip of the tube 2 cm, and head flexion can lower the tip 2 cm... With the head in a neutral position, the tube should be placed with the tip 5-7 cm above the carina... While tubes placed too deeply can cause a mainstem bronchus intubation, a shallow tube can lead to vocal cord injury or inadvertent extubation... Frequent checks of the endotracheal tube position as well as securing the tube are essential measures to ensure the tube stays in the correct position... Submitted by: Matthew Bonzani, 4th year Medical Student

No MeSH data available.


Subsequent radiograph.
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MPX2773_synpic1006: Subsequent radiograph.


Endotracheal tube malposition

Cunningham PJC - MedPix (2001)

Subsequent radiograph.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2773&req=5

MPX2773_synpic1006: Subsequent radiograph.

View Article: MedPix Image - MedPix Topic

Affiliation: Madigan Army Medical Center

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Complications of endotracheal intubation include acute laryngotracheal injury, tooth avulsion, laryngospasm, sinusitis, pneumothorax, edema of the vocal cords and glottis, pharyngeal injury, tracheal ulcers, epistaxis, aspiration of gastric contents, cardiac arrest, seizures, anoxic brain damage, and malpositioning of the endotracheal tube, including esophageal intubation... Accidental intubation of a mainstem bronchus will lead to absent breath sounds on the contralateral side with worsening atelectasis, tracheal deviation to the contralateral side, and hyperinflation of the intubated lung... Hypoventilation and hypoxemia may result... A chest radiograph will verify the position of the tube and help to exclude a pneumothorax... In a recent study involving intubated ICU patients, of 246 patients, radiographs demonstrated that 185 of the patients had malpositioned endotracheal tubes... In 107 patients the tube was at or above the level of the clavicles, while in an additional 78 the distal end of the tube was within 2 cm of the carina... Patient movement can account for many of these cases, as head extension can raise the tip of the tube 2 cm, and head flexion can lower the tip 2 cm... With the head in a neutral position, the tube should be placed with the tip 5-7 cm above the carina... While tubes placed too deeply can cause a mainstem bronchus intubation, a shallow tube can lead to vocal cord injury or inadvertent extubation... Frequent checks of the endotracheal tube position as well as securing the tube are essential measures to ensure the tube stays in the correct position... Submitted by: Matthew Bonzani, 4th year Medical Student

No MeSH data available.