This short course is designed to review the principles of airflow and the dramatic effects that a decreased radius has on airway resistance. The significance of the law of Hagen Poiseuille is reviewed, and additional scientific studies will be examined. After taking this into account, the potential patient benefits of an endotracheal tube cleaner system is examined. The indications, instructions, and procedure will be provided via printed materials and video. The impact of some longer term studies will also be considered.