• Ann Emerg Med · May 1998

    Case Reports

    Glottic positioning of the endotracheal tube tip: a diagnostic dilemma.

    • H A Werman and R E Falcone.
    • Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, USA. hwerman@magnus.acs.ohio-state.edu
    • Ann Emerg Med. 1998 May 1;31(5):643-6.

    AbstractDistal placement of the endotracheal tube tip in the glottic opening is rarely discussed in most emergency medicine, surgery, and prehospital medicine texts. We report three cases of glottic intubation recognized after the patients were thought to have been successfully intubated. Glottic positioning of the endotracheal tube tip went unrecognized initially because of the absence of air heard over the epigastrium, the presence of bilateral breath sounds, and acceptable readings by both pulse oximetry and capnography. Recognition of this complication is aided by the use of radiographic findings, inappropriate endotracheal tube depth, and the presence of inadequate ventilatory volumes. Potential complications of glottic intubation include dislodgement of the endotracheal tube, kinking of the tube, and inadequate protection of the airway.

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