Chest x-ray: ET tube position (summary)

Last revised by Craig Hacking on 4 Dec 2018
This is a basic article for medical students and other non-radiologists

Chest x-ray ET (endotracheal) tube position should be assessed following initial placement and on subsequent radiographs.

Reference article

This is a summary article; we have a more in-depth reference article, see ETT.


  • normal
    • tip 5 cm above carina
    • width 2/3 tracheal diameter
    • cuff should not expand the trachea
  • malposition
    • tip may extend past the carina
    • malposition most commonly seen is the tip in the right main bronchus
  • change in position
    • ET tube tip position is dependent on head position
    • tip position changes depending on neck flexion/extension
      • tip position may change by up to 2 cm
      • neck flexion moves the tip downwards
      • neck extension moves the tip upwards

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