A child presented with severe respiratory distress two days after bih. On examination he was observed to have a scaphoid abdomen and decreased breath sounds on the left side. He was managed by prompt Endotracheal intubation after ET tube placement. The maximal cardiac impulse shifted fuher to the right side. What should be the next step in management?
The ideal next step is remove the tube and reattempt intubation. But from the above given options the ideal one is nasogastric tube inseion amd decompression of the bowel. Confirmation of the position of the endotracheal tube by chest X-ray does not distinguish between oesphageal and tracheal intubation. Chest Xray is taken after the bowel is decompressed by nasogastric tube inseion to confirm the diagnosis. Surgery is performed once the patient has been stabilised, resuscitated and investigated. Ref: Bailey and love 24th Edition, Page 873; Lee synopsis of anaesthesia 13th Edition, Page 215
Confirm the position of endotracheal tube by chest X ray
Emergency surgery
Nasogastric tube inseion & decompress the bowel
Chest X ray to confirm diagnosis