If an endotracheal tube becomes dislodged during patient transport, what is the recommended action?

• A. Re-establish airway by re-intubation or using a rescue device; confirm with capnography and repositioning.
• B. Continue waiting without action.
• C. Remove tube and rely on mask ventilation.
• D. Replace with nasal trumpet.

Answer: (A)

When an endotracheal tube becomes dislodged during transport, the priority is to quickly re-establish a secure airway and ventilation. The best course is to re-intubate if feasible, or insert a rescue airway device to restore ventilation, then confirm proper tube placement with capnography (EtCO2 waveform) and reassess positioning. If needed, reposition the patient’s head and neck to improve the glottic view and facilitate re-intubation. Waiting or doing nothing risks rapid hypoxia; simply relying on mask ventilation after removing the tube is less reliable and does not safeguard the airway. A nasal trumpet cannot substitute for a secured airway in this scenario, as it does not protect the airway or ensure adequate ventilation. Capnography verification helps distinguish tracheal placement from esophageal intubation and guides safe continuation.