which could leave your patient in deep Trendelenburg for 5 hours, or
with patients who have intracranial lesions, says Dr. Sinha.
While edema is common during a long Trendelenburg procedure,
you need to take precautions following the operation, when it
might not be safe to remove the endotracheal tube due to respira-
tory distress caused by the swelling, says Dr. Sinha. He advises
using the balloon at the end of the endotracheal tube to ensure
that the patient is able to have the tube removed. If you deflate the
balloon, you should hear a leak around the tube that indicates the
airway is not swollen.
"You put the stethoscope on the patient's neck and as air leaks
around the tube, you can hear it," says Dr. Sinha, noting that the
absence of a leak is suggestive that you should leave the endotracheal
tube inserted until the possible swelling goes down.
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