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YOUR INTENSIVE CARE HOTLINE - Quick Tip for Families in Intensive Care: What Can be the Effect of an Intubation Tube, if it is 3 cm in the Wrong Place?

/ Patrik Hutzel - Critical Care Nurse Consultant / No Comments

Quick Tip for Families in Intensive Care: What Can be the Effect of an Intubation Tube, if it is 3 cm in the Wrong Place?

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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, I had an email from Yvonne who has her mom in intensive care for a few days and she says, “My mom’s been in ICU for a few days. She’s intubated and in an induced coma. Now, the intensive care team is telling me that the intubation (Endotracheal) tube is three centimeters in the wrong place. What can be the side effects of that?” Well, that’s a great question, Yvonne.

The question is this, you got to distinguish here two facts. One is, is it in by three centimeters or is it out by three centimeters? So, if it’s in by three centimeters, it might have gone into either the left or the right side of the lung, under ventilating one part of the lung. So, if it’s gone down into the trachea by three centimeters and it’s gone as far as the bifurcation and then it goes down the left side or the right side of the lungs, then one of the lungs would be hypo or under ventilated, that would show up in tidal volumes. It would show up in an X-ray. It would show up in arterial blood gases. It would show up in tidal volumes, pressures, and so forth. So, that would simply be a level of hypoventilation.

Then, the tube would need to be coming out by a few centimeters, followed up by a chest x-ray and making sure it’s in the right place, but then also making sure the volumes are fine, the pressures are fine, the arterial blood gases are fine, the right location has been confirmed in a chest x-ray. So, that’s one situation.

If it’s out by three centimeters, if it’s too high up, you might simply have a leak. Even though the breathing tube cuff is up, if the tube is sitting too high, again, there could also be a level of hypoventilation because there could be a leak. But then again, they should pick up on that pretty quickly by looking at volumes, by looking at peak pressures, by looking at chest x-rays, by looking at the arterial blood gases. So, the same checks and balances really apply by looking at all of that and they would probably find that there’s a level of hypo or under ventilation, which is probably why they picked up on it in the first place.

So, on both ends, the risks are pretty high, and they need to correct putting the breathing tube in the right place, making sure the volumes and the pressures are fine on the ventilator, making sure arterial blood gases are fine, and making sure the chest x-ray confirms the right position of the breathing tube. I hope that helps and I hope that answers your question.

That’s my quick tip for today.

If you have a loved one in intensive care and you need help, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, in a membership area and via email and we answer all questions, intensive care related.

Also, if you need a medical record review, we provide medical record reviews in real time. So, please contact us as well and then we can give you a second opinion in real time.

Also, I do one-on-one consulting advocacy over the phone via, Zoom, via Skype, WhatsApp, phone, whichever medium works best for you. I talk to doctors and nurses directly on your behalf. We can set up three-way calls. I can represent you in family meetings, and so forth so I can also give you a second opinion in real time.

If you need a medical record review after intensive care, please contact us as well if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence, please contact us as well.

If you are finding my videos valuable, please subscribe to my YouTube channel for regular updates for families in intensive care, click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next or what questions and insights you have from this video.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

 

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