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How to insert an endotracheal tube perfectly ?
The Procedure
Two team members should be involved in the procedure,
with one holding the maxilla with one hand while gently
using gauze to pull the tongue with the other hand to give
the other team member visual access to place the
endotracheal tube. Do not put any fingers in the patient's
mouth and, where applicable, use rolled gauze behind the
upper canine teeth to help hold the top jaw open.
Selecting Tube Size
Team members must select the right tube length and
placement technique to avoid inadvertent placement into
a lung. Various approaches can be used to evaluate
proper endotracheal tube size, including palpating the
patient's neck for tracheal size or holding the tube to the
nasal septum. With experience, team members will be
able to evaluate most patients and select the correct size
endotracheal tube, which should be measured from a
point immediately rostral to the upper incisors to the
thoracic inlet. Ideally, the team member who is intubating
the patient should have on hand a tube of the estimated
size needed; additional sizes should also be readily
available.
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