Confirmation of endotracheal intubation by combined ultrasonographic methods in the emergency department

Park, Soon Chang; Ryu, Jiho; Yeom, Seok Ran; Jeong, Jin Woo; Cho, Suck Ju

doi:10.1111/j.1742-6723.2009.01199.x

Cited by 73 publications

(50 citation statements)

References 16 publications

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“…[28293031] Moreover, ultrasonographic images are not affected by low pulmonary blood flow as compared to capnography. [32] Tracheal ultrasound detects esophageal intubation even before ventilating the patient, which prevents unnecessary forced ventilation to the stomach and its associated complications.…”

Section: Discussionmentioning

confidence: 99%

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Reliability of ultrasonography in confirming endotracheal tube placement in an emergency setting

Thomas

Paul

Rajeev

et al. 2017

Indian Journal of Critical Care Medicine

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Background and Objectives:Over the past few years, ultrasonography is increasingly being used to confirm the correct placement of endotracheal tube (ETT). In our study, we aimed to compare it with the traditional clinical methods and the gold standard quantitative waveform capnography. Two primary outcomes were measured in our study. First was the sensitivity and specificity of ultrasonography against the other two methods to confirm endotracheal intubation. The second primary outcome assessed was the time taken for each method to confirm tube placement in an emergency setting.Methods:This is a single-centered, prospective cohort study conducted in an emergency department of a tertiary care hospital. We included 100 patients with indication of emergency intubation by convenient sampling. The intubation was performed as per standard hospital protocol. As part of the study protocol, ultrasonography was used to identify ETT placement simultaneously with the intubation procedure along with quantitative waveform capnography (end-tidal carbon dioxide) and clinical methods. Confirmation of tube placement and time taken for the same were noted by three separate health-care staffs.Results and Discussion:Out of the 100 intubation attempts, five (5%) had esophageal intubations. The sensitivity and specificity of diagnosis using ultrasonography were 97.89% and 100%, respectively. This was statistically comparable with the other two modalities. The time taken to confirm tube placement with ultrasonography was 8.27 ± 1.54 s compared to waveform capnography and clinical methods which were 18.06 ± 2.58 and 20.72 ± 3.21 s, respectively. The time taken by ultrasonography was significantly less.Conclusions:Ultrasonography confirmed tube placement with comparable sensitivity and specificity to quantitative waveform capnography and clinical methods. But then, it yielded results considerably faster than the other two modalities.

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Section: Discussionmentioning

confidence: 99%

“…Our study was performed using tracheal sonography which is the most common ultrasound modality used for the same. [12131415161728293031323334353637] Transtracheal ultrasound has a sensitivity of 95.7%-100% and a specificity of 96.3%-100% in identifying ETT placement. [38]…”

Section: Discussionmentioning

confidence: 99%

Reliability of ultrasonography in confirming endotracheal tube placement in an emergency setting

Thomas

Paul

Rajeev

et al. 2017

Indian Journal of Critical Care Medicine

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“…This may be supplemented with transthoracic ultrasonography, but the latter requires ventilations for confirmation. 5,6 One limitation of this study was the use of capnography as the reference standard, which has imperfect sensitivity and specificity. 2 …”

Section: Commentarymentioning

confidence: 99%

Can Transtracheal Ultrasonography Be Used to Verify Endotracheal Tube Placement?

Gottlieb

Bailitz

2015

Annals of Emergency Medicine

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“…Combination of transcricothyroid membrane ultrasonography and ultrasonographic lung-sliding evaluation was found to be a sensitive and specific way of confirming endotracheal intubation in emergency department. 34 Ultrasound screening of pretracheal vascular structures before percutaneous dilatational tracheostomy may minimize the risk of bleeding. 35 Before percutaneous dilatational tracheostomy, portable ultrasonic scanning of anterior neck is particularly beneficial for patients with landmarks that are difficult to visualise or palpate.…”

Section: Airway Managementmentioning

confidence: 99%

Point-of-care Ultrasonography in Critically Ill Patients

2015

Kathmandu Univ. Med. J.

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Point-of-care ultrasonography has been used frequently by the physicians involved in managing critically ill patients. It allows direct visualization of pathology or abnormal physiological state at the bed side. The examination may be safely and effectively repeated as needed to follow the evolution of illness and the response to therapy. It is helpful to guide the therapy in patients with undifferentiated shock and for bedside diagnosis of common pathological conditions in acute care setting. It can facilitate common bedside procedures and interventions.

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Confirmation of endotracheal intubation by combined ultrasonographic methods in the emergency department

Abstract: The combination of transcricothyroid membrane ultrasonography and ultrasonographic lung-sliding evaluation could be useful in confirming endotracheal intubation in the ED.

Cited by 73 publications

References 16 publications

Reliability of ultrasonography in confirming endotracheal tube placement in an emergency setting

Reliability of ultrasonography in confirming endotracheal tube placement in an emergency setting

Can Transtracheal Ultrasonography Be Used to Verify Endotracheal Tube Placement?

Point-of-care Ultrasonography in Critically Ill Patients

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