ETT in right main bronchus

Case contributed by Derek Smith
Diagnosis certain

Presentation

Cardiac arrest. Asymmetric chest movement following intubation. Check ETT placement.

Patient Data

Age: 50
Gender: Female
x-ray

ETT tube in the right main bronchus. Should be removed at least 5 cm to be above carina.

Right internal jugular central venous catheter. Tip in SVC. No pneumothorax.

Collapse of the unaerated left lung, with background airspace opacification on the right.

Case Discussion

The endotracheal tube has been advanced into the right main bronchus. In doing so, the tube is occluding the air supply to the left lung which in turn has collapsed.

This was fixed by extracting the ET tube a few centimeters to sit above the carina.

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