Question

Upon review of the chest radiograph after an elective intubation, the respiratory therapist notes that the distal tip of the endotracheal tube is 3 cm above the carina. How should the therapist interpret this finding?

1) The tube is above the recommended position.
2) The tube is too long for this patient.
3) The tube is in the proper position.
4) The tube is below the proper position.

Answer 1

The endotracheal tube's position at 3 cm above the carina signifies that it is correctly placed, as recommended is for it to be 3-5 cm above the carina.

Step-by-step explanation:

The correct interpretation of the endotracheal tube's position being 3 cm above the carina is that the tube is in the proper position. When performing an intubation, the placement of the endotracheal tube is crucial for ensuring adequate ventilation and to prevent accidental injury or complications.

The recommendation is for the tube tip to be approximately 3-5 cm above the carina, which is the point where the trachea divides into the left and right mainstem bronchi. A position too far above may lead to accidental extubation, while a position too deep may result in one-lung intubation if the tube enters one of the main bronchi. Additionally, it's important that this assessment is made when the neck is in a neutral position to avoid displacement caused by changes in head posture.