Shaping the ETT correctly in infants!

The traditional hockey stick bend angle of 30 - 35 degrees is used with curved Macintosh blades in older children and adults. Some amount of curve is necessary with curved blades to improve maneuverability and provide directional control over the tip of the tube. In neonates, infants and toddlers, straight blades are commonly preferred. Due to the small size of the glottis, and the overall target area, precise control over the tip of the ETT (Endotracheal Tube) is needed to direct the ETT into the glottis. A gentle curve at the tip of a styletted ETT (10-15 Degrees) provides for a short radius of curvature around which the ETT tip can move (Figure 1). Twisting the ETT on its own axis helps the provider direct the ETT precisely into the glottis (Figure 2). If the curve at the tip of the tube is > 10-15 degrees, the result will be a larger radius of curvature, and loss of precise directional control over the tip

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