Monday, April 1, 2019

ETT bending

Q: During intubation, an endotracheal tube (ETT) should be bent no more than?

A) 20 degrees
B) 35 degrees
C) 45 degrees
D) 60 degrees
E) 90 degrees ("hockey stick" conformation)

Answer: B

This is a common practice of some senior residents to teach junior residents to put ETT at "hockey stick" conformation if difficult intubation is anticipated. This should be done only and only in very experienced hands. Ideally, ETT should never be bent > 35 degrees. Beyond that, more acute angles may cause the ETT to get stuck on the anterior trachea, prevent advancement and injured trachea.



Levitan RM, Pisaturo JT, Kinkle WC, et al. Stylet bend angles and tracheal tube passage using a straight-to-cuff shape. Acad Emerg Med 2006; 13:1255.

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