After intubating a patient, which action best confirms the placement of the endotracheal tube?

• A. Assess chest rise symmetry
• B. Obtain a chest radiograph
• C. Auscultate breath sounds
• D. Examine tube markings near the lips

Answer: (B)

The most accurate method to confirm the placement of an endotracheal tube is to obtain a chest radiograph. A chest X-ray provides a visual confirmation of the tube's position, ensuring that it is correctly placed within the trachea and not in the esophagus or other incorrect locations. This imaging technique allows for the assessment of tube depth and appropriate positioning, which is critical for effective ventilation.

While assessing chest rise symmetry, auscultating breath sounds, and examining tube markings can provide useful preliminary information about the position, they are not definitively reliable on their own. Chest rise symmetry can indicate that the tube is in the trachea, but it is not conclusive. Auscultation of breath sounds can suggest correct placement if breath sounds are present bilaterally; however, absent or diminished breath sounds do not automatically indicate an incorrect position, as other factors may be at play. Examining tube markings near the lips can give a rough estimate of the placement depth but does not confirm placement as accurately as a chest radiograph can. Thus, while those actions contribute to the overall assessment, they do not provide the definitive confirmation that a chest X-ray does.