Inadvertent intubation of the left mainstem bronchus

This is a case report of a previously healthy 61-year-old white male who was emergently intubated in the field by paramedical personnel and transported to the emergency department. Physical examination revealed minimal-to-absent breath sounds over the right hemithorax associated with cyanosis of the head, face, and upper extremities. Emergency needle decompression of the right lung was accomplished without improvement. A postmortem chest radiograph revealed a left mainstem bronchus intubation. Use of the physical examination, the endotracheal tube depth, and an awareness of the possible--but rare-complication of left mainstem bronchus intubation may lead to accurate diagnosis and treatment and avoid unnecessary procedures.