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September 15, 1956


JAMA. 1956;162(3):194-196. doi:10.1001/jama.1956.72970200003008b

The vexing problem of a partially obstructed endotracheal tube has been encountered twice recently during the course of administration of anesthetics. Roentgenograms were helpful in demonstrating exactly why the tube was obstructed and what happened when the position of the tube was changed to correct the obstruction. In each case the bevel of the endotracheal tube rested against the anterior wall of the trachea. I have found only two references1 to this problem.

Report of Cases 

Case 1.—  A very ill 84-year-old male had a marked kyphosis and a rigid, extended cervical spine. Two large pillows were required to support his head. He was anesthetized and intubated in preparation for a laparotomy. The airway was clear until the metal elbow was disconnected from the curved plastic endotracheal tube to perform endotracheal suction. I assume that the unnatural position of the head caused this curved tube to rotate unnoticed. Soon