The intubation depth marker: the confusion of the black line

BACKGROUND: Estimation of the correct depth of insertion of a tracheal tube (TT) in children is extremely important. Insertion of an excessive length may result in endobronchial intubation while an inadequate length of insertion may lead to accidental extubation. METHODS: We reviewed TTs commonly used in paediatric practice and also reviewed recommended guidelines for correct depth of insertion. RESULTS: Amongst the different brands of TTs used, there was a wide discrepancy in the placement of the intubation depth marker. This is important as the intubation depth marker is often used as a guideline for intubation. CONCLUSIONS: For optimal placement we can rely on various formulae and manufacturers' markings on the TTs. Clinical judgement, however, remains the cornerstone of optimal placement.