ICU Chest Films > Lines and Tubes > Endotracheal Tubes > Alternative Method for Locating Carina
Endotracheal Tubes: Alternative Method for Locating Carina
Look
at the x-ray image to the left. Notice that the carina is not
visible (not an uncommon occurrance). What now? A previous chest
ray can be used to estimate the position of the carina, or the
carina can be assumed to be at the T4-T5 interspace, given that
95% of patients' carinas project over the T5, T6, or T7 vertebral
bodies.
Alternatively, the Dee method for approximating the position of the carina can be used. This involves defining the aortic arch and then drawing a line inferomedially through the middle of the arch at a 45 degree angle to the midline. The intersection of the midline and the diagonal line is the most likely position of the carina.
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to see Dee Method