There is a sweet spot of Endotracheal tube (ETT) depth between the carina and the glottis. Placement outside of this area makes your lifesaving intervention ineffective. Here are a few pearls:

Depth: Needs to be individualized, suggested starting with: - ~21cm adult females - ~23cm adult males - Individualized for peds (3xsize of ETT used)

Secure and DOCUMENT placement of ETT, including on ACR - Measured AT THE TEETH (not the lips) - Allows for reassessment with movement

Positioning: Movement of the head/neck causes movement the ETT - Neck FLEXION cause the ETT to go deeper (can result in mainstem intubation) - Neck EXTENSION causes the ETT to move upwards (can result in extubation)

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