What are standard signs that tube placement is correct after endotracheal intubation?

• A. Equal bilateral chest rise, equal breath sounds, presence of a capnography waveform, absence of air leak around tube
• B. Unequal chest rise and breath sounds; no capnography
• C. Breath sounds only on one side; no chest rise
• D. Radiographic confirmation only

Answer: (A)

When you place an endotracheal tube, the goal is to confirm the tube is in the trachea and delivering air to both lungs. The most reliable real-time indicators are a symmetric chest rise with ventilation and breath sounds heard on both sides, plus a capnography waveform showing a consistent CO2 pattern. The capnography confirms that exhaled gas contains CO2, meaning the tube is in the airway and not in the esophagus. The absence of an air leak around the tube’s cuff can support that the cuff is seated properly, helping ensure a seal, but the critical confirmations come from the bilateral chest movement, bilateral breath sounds, and the CO2 waveform. Radiographic confirmation is important, but it serves as a supplemental check after the initial clinical and capnographic verification rather than the sole or immediate confirmation.