Displaced ETT in prone position
Discussion was around how to secure a tube for a patient going prone and what to do if a tube “falls” out while in the prone position (with the notion that it was/would be virtually impossible to re-intubate whilst still prone).
Crisis management of a displaced tube in prone position (one possible strategy):
- Inform theatre team of need to flip patient supine ASAP
- Anaesthetist
- Activate Scout Nurse
- 10L 100% oxygen
- Insert LMA
- Give muscle relaxant
- Remember to keep patient anaesthetised
- Scout Nurse
- Get anaesthetic help
- Call for orderlies
- Bring patient bed in
- Re-intubate patient in supine position
- Secure ETT using different fixation method
Securing ETT for prone position:
Range of techniques suggested. Choice will also depend on surgical access required.
Remember to leave an exit for saliva!
Links:
St George Anaesthesia Education 