How can you assess proper tube placement in an intubated patient?

Assessing proper tube placement in an intubated patient is crucial for ensuring adequate ventilation and oxygenation. The most effective approach involves a combination of auditory and visual methods.

Using bilateral breath sounds is essential because it confirms that air is moving into both lungs. A clinician listens to the patient's chest on both sides; equal and clear breath sounds indicate that the endotracheal tube is likely positioned correctly within the trachea and not in the esophagus or obstructing one bronchus.

Capnography provides a real-time measurement of exhaled carbon dioxide, which is critical for verifying tube placement. In a correctly placed tube, the capnography will show appropriate levels of CO2 with each exhalation, indicating that the ventilatory support is reaching the lungs.

Visual confirmation includes inspecting the tube’s position at the lips and ensuring there are no signs of misplacement, such as excessive tube movement or abnormal positioning.

By integrating these three assessment techniques—bilateral breath sounds, monitoring capnography, and visual confirmation—clinicians can confidently determine whether the endotracheal tube is correctly placed, ensuring the patient's safety and effective ventilation.