Learning reflection
1 . Briefly explain which anatomical structures the endotracheal tube ( ETT ) is measured against prior to intubation , to ensure it is the correct length . What would happen if the ETT is too long for the patient ?
2 . Briefly describe how an endotracheal tube should be checked prior to use .
3 . Briefly explain how an endotracheal tube should be cleaned following use , and prepared for the next patient .
Answers
1 . The length of the endotracheal tube ( ETT ) should be measured to reach cranial to the bronchial bifurcation , by placing the ETT against the side of the patient from the jaw to the thoracic inlet . Once placed , the ETT will sit at the level of the incisors to minimise dead space . If the tube is too long , it may slip into one bronchus preventing oxygen delivery to the other lung .
2 . The ETT should be visually inspected to ensure it is clean and there are no signs of damage . Ensure that the inside of the ETT is also checked for cracks and debris . The cuff should be inflated at the earliest opportunity , and left as long as possible ( ideally at least 10 minutes ) prior to intubation .
3 . Inflate the ETT cuff and manually rinse and wipe away any debris , mucus and fluid that may be on the tube . Long thin brushes can be pushed into the tube and down the lumen to remove any material inside the tube . The tube can then be placed into an enzymatic instrument and cleaning solution , which is designed to dissolve and further remove proteinaceous and organic material , such as saliva , blood and mucus . The ETT should be soaked for the instructed amount of time , rinsed and placed into a high-level instrument disinfectant solution . A Milton sterilising solution may also be used . The ETT should then be thoroughly rinsed , including the lumen . The outside can be dried with a paper towel ; shaking the tube may remove some water from the inside . It should be placed on a rack to continue to dry . Finally , the cuff should be deflated and the ETT stored on the appropriate rack ready for use .
Reflective professional development notes . To access hyperlinks to the references , scan the QR code on page 3 .
58 Veterinary Nursing Journal