ET size HELP!

Specialties MICU

Published

I have this adult patient, in DNR and GCS 7/15 state, to be trans-out to regular room on MV from the ICU. The patient was endorsed to me intubated from ER with no ET size indicated but only the level 2 shifts prior to my shift. How can I identify the ET size if it was inserted already and the ER doctor, who intubated, is not present to seek for answer? I endorsed the said patient with an ASSUMED ET size for adult....I know it's wrong but I'm trying my best not to do it again. :crying2: I'm still fresh from being an ICU nurse.

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Not sure what company provides your ET tubes, but ours have the diameter at the top in bold black numbers. Also you should have a code blue/intubation sheet if it was performed in the hospital. If you're missing the sheet someone messed up.

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Not sure what company provides your ET tubes, but ours have the diameter at the top in bold black numbers. Also you should have a code blue/intubation sheet if it was performed in the hospital. If you're missing the sheet someone messed up.

That's the problem...we do have a code blue sheet but instead, the ER doc writes the scenario on the order sheet. There was no legal document...:crying2:

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Specializes in CRNA.

in the future, the size of the ett is not something i would spend time trying to solve. basically, if you see rise and fall of the chest, your mean airway pressures are acceptable and the patient has etco2....life is good. if you want to worry about something concerning the ett, i would focus on knowing the depth of the tube on arrival to your floor as well as listening for bilateral breath sounds to ensure the patient did not get a main stem intubation from the transfer.

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Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

The size is usually embossed on the underside of the "wings" of the 15mm connector (where the vent tubing attaches). It can be hard to see because the numbers are pretty small. I'll try to post a link if I can find one.

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Specializes in CVICU.

I've never seen an ETT that didn't have the diameter printed right close to the open end of it that sticks out of the patient's mouth. The most common sizes I see are 7, 7.5, and 8.

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Unless the tube has been cut by the person who intubated (sometimes pesky docs do it for their convenience), the size is always printed on the tube near the top. However, if you have RRT's working with you, just ask one of them and they'll be glad to tell you.

Also, as long as the airway is patent and secure, the size of the tube is not that high a priority. The depth of tube insertion and tube position via CXR is more important.

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Specializes in ICU.

Also, one tip I learned from one of our RT's is that half-sizes (e.g. 7.5) have the cm-markings in odd numbers (e.g. 21,23,25) and the full sizes (e.g. 8.0) have the cm-markings in even numbers (e.g. 22,24,26).

:paw:

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Specializes in Med/Surg ICU.

I caution nurses from "rocking the boat" because a code sheet was not filled out...if it was not a code when the pt got intubated then there would not be a code sheet...at least at my facility

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Specializes in ER, Critical Care, Paramedicine.

Yup, its printed on the ETT itself... If wiped off, easiest way is to get a 7 7.5 and 8 and measure diameters of the two...

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I caution nurses from "rocking the boat" because a code sheet was not filled out...if it was not a code when the pt got intubated then there would not be a code sheet...at least at my facility

Our sheet is labeled "Code Blue/Intubation Report" so it HAS to be filled out. I'm sure other places are different though.

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under the connector hub of the ETT are the numbers, they are hard to see. A trick is to press your bare finger underneath the flange. The numbers will be pressed into your skin and you can then read them.

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