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Updated: Jul 28, 2026

The Rigid Tube as an Alternative in Controlling the Problematic Airway

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Published on: June 6, 2020

Intubation guide marks for correct tube placement. A clinical study.

¹Department of Anaesthetics, Burnley General Hospital, Lancs.

|April 1, 1991

Summary

Accurate tracheal tube placement is crucial for patient safety. This study recommends using specific guide marks on tracheal tubes to ensure correct positioning, reducing risks associated with intubation.

Area of Science:

Anesthesiology
Critical Care Medicine
Respiratory Therapy

Background:

Proper endotracheal tube (ETT) placement is vital for effective mechanical ventilation and preventing complications.
Inaccurate ETT positioning can lead to airway injury, esophageal intubation, or endobronchial intubation.

Purpose of the Study:

To evaluate the effectiveness of pre-placed guide marks on tracheal tubes for accurate positioning.
To determine optimal guide mark distances for adult males and females.

Main Methods:

140 adult patients underwent tracheal intubation using TFX or Portex tubes with pre-printed guide marks.
Guide marks were aligned with vocal cords during intubation.
Fiberoptic bronchoscopy measured the distance from the tube bevel to the carina.

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Main Results:

Mean distance from the tracheal tube tip to the carina ranged from 3.7 to 4.1 cm in neutral head position.
Head extension to neutral position moved the tube tip 0.5 cm closer to the carina.
Recommended guide mark placement: 2.5 cm for males, 2.25 cm for females.

Conclusions:

Pre-placed guide marks offer a simple, safe, and reliable method for correct tracheal tube placement.
Specific guide mark distances can optimize positioning for adult males and females.
This technique enhances patient safety during intubation procedures.