Ain-Shams Journal of Anaesthesiology

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

Significance of preoperative endotracheal tube check

Ramaiah M Mohan Kumar, Nataraj M Srinivasan 
 Department of Anaethesiology, Employees State Insurance Corporation Medical College, Bangalore, Karnataka, India

Correspondence Address:
Ramaiah M Mohan Kumar
Department of Anaesthesiology, Employees State Insurance Medical College, Bangalore - 560 010, Karnataka

How to cite this article:
Mohan Kumar RM, Srinivasan NM. Significance of preoperative endotracheal tube check.Ain-Shams J Anaesthesiol 2015;8:461-462

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 Nov 29 ];8:461-462
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Full Text

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}

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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Conflicts of interest

There are no conflicts of interest.


1Dorsch JA, Dorsch SE eds. Understanding anesthesia equipment. 5th ed. NY, USA: Lippincott Williams and Wilkins; 2007.
2Parthasarathy S, Ravishankar M. Tight bag. Indian J Anaesth 2010; 54:193-198.
3Nataraj SM, Sreelakshmi DG, Bharathi NR. Bronchospasm: not always the cause for tight bag. J Anaesthesiol Clin Pharmacol 2013; 29:284-285.