Endotracheal Tube Position on a Chest X-Ray (TMC Practice Question)

This video breaks down a sample TMC Practice Question about the endotracheal tube position on a chest radiograph.
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➡️ Question:
A 61-year-old female was just intubated and is now receiving ventilatory support via an oral endotracheal tube. You recommended a chest radiograph in order to confirm proper placement of the tube. Where should the tip of the tube be positioned?
A. Not more than 2 cm above the carina
B. At the same level as the carina
C. Level with the fifth cervical vertebra
D. Between the 2nd and 4th thoracic vertebra

➡️ Rationale Explanation:
You absolutely must know the proper position of an endotracheal tube for the TMC Exam because you will see questions about it. Just know that there are a few ways to confirm proper placement that you should be familiar with. When looking at a chest x-ray, a properly positioned ET tube should appear about 1.5 inches above the carina which, to be more specific is about 4-6 cm. This means that the tip of the tube will sit between the 2nd and 4th thoracic vertebra on the x-ray.

➡️ Another quick and general reference to look for is this:
The tube should be inserted about 21-24 cm at the patient’s lip, which you can verify by looking at the markings on the tube. So, by looking at the answer choices, we can quickly see that only one option shows that the tube is in the correct place.

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This content is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you watch in this video. We strive for 100% accuracy, but errors may occur, and medications, protocols, and treatment methods may change over time.

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⏰TIMESTAMPS
0:00 - Intro
0:37 - Practice Question
1:16 - Explanation
2:20 - Correct Answer

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