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Year : 2015  |  Volume : 8  |  Issue : 3  |  Page : 461-462

Significance of preoperative endotracheal tube check

Department of Anaethesiology, Employees State Insurance Corporation Medical College, Bangalore, Karnataka, India

Date of Submission21-Jan-2015
Date of Acceptance21-Jun-2015
Date of Web Publication29-Jul-2015

Correspondence Address:
Ramaiah M Mohan Kumar
Department of Anaesthesiology, Employees State Insurance Medical College, Bangalore - 560 010, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1687-7934.161741

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How to cite this article:
Mohan Kumar RM, Srinivasan NM. Significance of preoperative endotracheal tube check. Ain-Shams J Anaesthesiol 2015;8:461-2

How to cite this URL:
Mohan Kumar RM, Srinivasan NM. Significance of preoperative endotracheal tube check. Ain-Shams J Anaesthesiol [serial online] 2015 [cited 2021 Oct 26];8:461-2. Available from:

It is well-known how important a preoperative anesthesia machine and apparatus check is. Even though checking the endotracheal tube (ETT) is also a part of this process, the significance of checking the ETT connector has not been emphasized [1] . While checking ETT, it is routine to check for any cuff leak or any obvious break in the continuity of the tube. Here, we would like to emphasize the other manufacturing defects present in the ETT and hence the need for a thorough checking of tubes including the connector in the routine preoperative apparatus checks.

A 5-month-old infant weighing 5 kg was scheduled for cleft lip and palate repair. The child was otherwise normal, with no anticipated difficulty in securing the airway. While selecting the ETT for the child, it was noticed that the proximal lumen of 3.5 mm ETT (Lifeline Medical Systems, Noida, India) connector was unusually narrow [Figure 1]. On opening the tube and removing the connector, it was found to be a manufacturing defect with a narrow lumen of the connector.
Figure 1: Defective endotracheal tube connector with a narrow lumen compared with a normal one on the right side

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Later on, the trachea was intubated with a normal 3.5 mm tube (Smiths Medical International Ltd, UK) and the procedure was uneventful.

The causes for tight bag under anesthesia have been discussed extensively [2] . There has also been a case report mentioning another cause for tight bag, in which a similar manufacturing defect was noted, albeit, on the patient end of the connector (Sterimed, India) [3] . Therefore, manufacturing defects are becoming quite common (in fact, another 3.0 mm ETT of the same company was found to have a small lumen too). In third-world countries, especially in government hospitals, where cost becomes an important factor in selecting ETT and other equipment, such defective products may be encountered more commonly. Moreover, use of such defective products can put the patient at risk if a thorough check of ET tubes including checking for manufacturing defects is not emphasized.

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There are no conflicts of interest.

  References Top

Dorsch JA, Dorsch SE eds. Understanding anesthesia equipment. 5th ed. NY, USA: Lippincott Williams and Wilkins; 2007.  Back to cited text no. 1
Parthasarathy S, Ravishankar M. Tight bag. Indian J Anaesth 2010; 54:193-198.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
Nataraj SM, Sreelakshmi DG, Bharathi NR. Bronchospasm: not always the cause for tight bag. J Anaesthesiol Clin Pharmacol 2013; 29:284-285.  Back to cited text no. 3
[PUBMED]  Medknow Journal  


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