What is the recommended action regarding endotracheal tube after ROSC if airway is secured?

• A. Remove the Tube
• B. Confirm Endotracheal Tube Position and Patency
• C. Do Not Verify Position
• D. Reinsert If the Patient Moves

Answer: (B)

After ROSC, if the airway is secured, the priority is to verify that the endotracheal tube remains in the correct position and is patent. Movement during resuscitation and transport can displace or kink the tube, leading to ineffective ventilation or mainstem intubation. The most reliable way to confirm placement and ongoing patency is continuous waveform capnography, which provides real-time confirmation that the tube is in the trachea and that ventilation is occurring. Complement capnography with other checks such as observing bilateral chest rise, listening for equal breath sounds, and confirming the tube depth at the teeth or gums. If there’s any doubt about position or patency, reassess promptly and take appropriate action; avoid assuming correct placement without verification.