Proper management of the endotracheal tube is a critical and often overlooked aspect of care for patients receiving mechanical ventilation. Clinicians must take measures to prevent complications related to the tube, and must recognize and treat these complications if they do occur. An endotracheal tube should be placed and maintained so that the end of the tube is two to six cm above the carina. In an average adult with an orally placed endotracheal tube, the distal tip of the tube is usually appropriately positioned midway between the vocal cords and the carina when the tube is between the 18- and 24-cm mark measured at the incisors.
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