Correct positioning of an endotracheal tube using a flexible lighted stylet.

Endotracheal intubation is not without complications, among the most serious of these being misplacement of the endotracheal (ET) tube. Unrecognized esophageal placement is a lethal complication, but even when placed in the trachea, ET tubes can be displaced distally and enter a mainstem bronchus. Correct positioning of an ET tube is usually defined as the placement of the tube within the trachea approximately 5 cm above the carina.

Use of a lighted stylet to confirm correct endotracheal tube placement.

Despite the fact that endotracheal intubation is a skill essential for clinicians of varied specialties, the procedure is not without risk, especially when practiced in an emergency setting, particularly the field environment. Of all complications, none is more serious than unrecognized esophageal intubation. Clinical experience with a method of guided orotracheal intubation using a rigid-wire lighted stylet prompted us to develop a technique to confirm correct intratracheal placement of an endotracheal tube using a new flexible lighted stylet designed for nasotracheal intubation.