Fig. 6
From: Double lumen endobronchial tube intubation: lessons learned from anatomy
Suggested steps in double lumen endotracheal tube intubation. (1) Advance the tip of the double lumen tube facing anteriorly into the glottic opening. (2) Remove stylet and straighten any bend in the tube as much as possible avoiding any forward motion. (3) Rotate the tip of the tube a full 180 degrees to face posteriorly again avoiding forward motion. (4) Carefully and with little force advance the tube until the tracheal balloon is entirely within the airway, then rotate tip back 90 degrees to the designated side (L vs. R) and advance to the desired bronchus. Confirm final position with flexible bronchoscopy