Sling Gauze Technique for the Positioning of RAE Tube in InfantsUndergoing Head and Neck Surgeries

Abstract

In order to maintain anaesthesia with minimal complications, one of the vital steps is securing a stable oral endotracheal tube. The endotracheal tube may be displaced and become unstable due to suctioning, change in the position of the head and patient care. Poor fixation of the endotracheal tube is one of the leading causes of accidental extubation. The ideal endotracheal tube stabilisation method must allow changes in position of the infant during care while simultaneously minimising movement of the tube. The relatively short tracheal length in small children and infants is a major reason why placing the endotracheal tube (ETT) in the proper position may be difficult. The endotracheal tube may migrate cephalad with neck extension and caudally with neck flexion due to changes in the position of the head, such as extension or flexion of the neck. Sometimes, a well secured tube may also cause abnormalities in ventilation due to the dynamic positioning during surgeries on the cranium. Here, we present to you a technique where the oral endotracheal tube fixation
at the lips, can be manoeuvred to change its depth of insertion by millimetres by a simple easily available device in the operation theatre.