photo-1792581054299.jpg
Explain
Reading File
analyse_media
Finding Sources
Searching PubMed
endotracheal tube malposition
Searching the Web
endotracheal tube right mainstem intubation absent left breath sounds chest radiograph
Reading File
This is right mainstem bronchus intubation.
- The endotracheal tube has been advanced too far and has entered the right main bronchus.
- Therefore, ventilation is going mainly to the right lung, where breath sounds remain vesicular.
- The left lung is under-ventilated and collapses (left-sided atelectasis), contributing to falling oxygen saturation.
Expected finding on the left: markedly decreased or absent breath sounds.
Why it happens: the right main bronchus is more vertical and wider, so an overly advanced tube commonly enters it. Management is to withdraw the tube slightly, reassess bilateral air entry, and confirm its position on chest radiograph. The tube tip should normally lie a few centimeters above the carina. This is also why anesthesia teaching recommends withdrawing a tube advanced into the right main bronchus until bilateral breath sounds are equal (Morgan and Mikhail text excerpt).
This is a shared conversation. Sign in to Orris to start your own chat.