How to determine the proper placement of the ETT
- 1. Check to see that the tube is inserted at a depth that is three times the internal diameter of the ETT (from the point of the patient’s central incisors).
- 2. Observe for symmetric chest expansion.
- 3. Auscultate for symmetric breath sounds.
- 4. Look for distention of the abdomen, indicating misplacement of the tube.
- 5. Measure end-tidal carbon dioxide using a colorimetric detector. In infants and children with a perfusing rhythm, a purple color on the device indicates a problem, whereas a yellow color implies that the tube is in the trachea.
- 6. Confirm tube placement with a chest radiograph.
How to determine if the ETT is appropriately placed?
Proper depth for ETT insertion from the point of the patient’s central incisors can be estimated to be three times the internal diameter of the ETT. Measurement of end-tidal carbon dioxide using a colorimetric detector, observation for symmetric chest expansion, and auscultation for symmetric breath sounds can help to ensure proper placement. Confirmation of placement is probably best determined with a chest radiograph. Prior to a chest radiograph, the colorimetric detector offers a rapid bedside determination to detect CO 2 to confirm ETT placement