Middle fingertip to rascette line measurement novel approach to endotracheal tube depth for Filipinos: A pilot study

ABSTRACT

@#A predetermined endotracheal tube depth prior to intubation ensures correct tube placement relative to the carina. The objective of this study was to determine if the topographic measurement from the middle fingertip (MFT) to Rascette line (RL) or "wrist line" correlates with acceptable endotracheal tube (ET) depth during orotracheal intubation. This was a prospective, analytical cross-sectional pilot study of 54 adult Filipino patients who underwent general anesthesia with orotracheal intubation. The middle fingertip to Rascette line measurement was utilized as the basis for endotracheal tube depth with ET secured on the right corner of the mouth. After intubation, a chest x-ray was performed to measure the distance from the endotracheal tube tip to the carina. The study showed that the average middle fingertip to Rascette line measurement among Filipinos was 18.79cm (± 1.08) which resulted in 85.19% of patients with ET tip to carina within the acceptable distance of 2-Scm, with a mean value of 3.17cm. The mean MFT to RL measurement in females was 18.28cm and 19.81 cm in males. The mean distance of ET tip to carina in females was 2.91 cm and 3.66cm in males. There was a significant positive correlation between the middle fingertip to Rascette line measurement and height. This study also documented the total length from the right corner of the mouth to carina, by adding middle fingertip to Rascette line measurement and the distance from ET tip to carina, resulting in a mean value of 23.46cm (±2.06) in males and 21.19 cm (±1 .73) in females. In conclusion, middle fingertip to Rascette line measurement is an acceptable technique to determine individualized endotracheal tube depth during orotracheal intubation. This topographic measurement resulted in 96.29% of ET tip? 1 cm above the carina.