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m y figure 39-5 Insertion technique if placement is unusually difficult. A, Umbilical tape passed through the T tube sidearm and the proximal vertical arm is retrieved from the tracheal stoma via the rigid bronchoscope and pulled through the bronchoscope. B, The T tube insertion is commenced in the usual way, and then a clamp placed across the sidearm of the tube to fix the tape firmly.

figure 39-5 (continued) C, Firm traction is made on the tape through the bronchoscope to draw the proximal vertical arm into the trachea. The tape is then withdrawn.

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