g. Check the placement of the endotracheal tube. To check the placement:
(1) Breathe through the tube while someone auscultates the two lower lung
fields and the paraumbilical (area alongside the navel) regions to check tube placement.
(2) If sound is heard over one lung field (usually the right) more than the
other, you must back up the tube a little and listen again?
If a rushing sound is heard over the abdomen with diffuse sound over the
lower lung fields, you have missed the larynx and gone down into the
pharynx. You should remove the tube, reoxygenate the casualty, wait three
minutes, and try again.
Figure 2-10. Properly placed endotracheal tube.
h. Inflate the cuff with 5 to 10 ml of air.
Reoxygenate the patient with two slow breaths.
j. Clamp the tube (optional) and remove the syringe.
k. Connect the resuscitative equipment (BVM or 02 with demand valve).
Ventilate once every 5 seconds.
m. Secure the tube.
n. Monitor the casualty periodically with auscultation to be sure the endotracheal
tube is placed correctly.
Be sure the casualty is NOT without oxygen for longer than 30 seconds
at a time.