Understanding Anesthesiology - The Global Regional Anesthesia ...

Esophageal intubation
Esophageal intubation is the unintentional placement of the endotracheal tube into the
esophagus rather than into the trachea.
Esophageal intubation must be recognized to avoid serious complications such as hypoxia
and aspiration. Auscultation of the the chest during manual ventilation reveals the absence
of air entry and the chest will not rise in the usual fashion. Auscultation of the epigastrium
reveals low-pitched gurgling sounds. The capnograph usually shows no CO2 return (although
it is possible to have some CO2 return if CO2 was forced into the stomach during
bag mask ventilation).
When an esophageal intubation is recognized, one stops manual ventilation to avoid inflating
the stomach and removes the misplaced endotracheal tube. Bag mask ventilation is resumed
while preparations are made to optimize the chances of success for the next attempt
at intubation.
Related Glossary Terms
Bag mask ventilation, Capnograph, Difficult airway, Direct laryngoscopy, Hypopharynx, Hypoxemia,
Intubation
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Chapter 1 - Airway Management