The Sensitivity and Specificity of Transcricothyroid Ultrasonography to Confirm Endotracheal Tube Placement in a Cadaver Model

Use of Cadaver Models in Point-of-care Emergency Ultrasound Education for Diagnostic Applications

“…Delaunoy et al and Hong et al demonstrated that injecting normal saline into cadaver joints provided a model to detect joint effusion in knees (11,12). Additionally, studies have shown that cadaver models are useful in answering important clinical questions such as the sensitivity of US to localize small soft-tissue foreign bodies and the ability of US to confirm endotracheal tube placement and intraosseous needle placement (13,14,18). As in previous studies, our study demonstrated that qualitatively, freshly frozen cadavers can be effective models for joint effusion.…”

Applications of Ultrasonography in ENT: Airway Assessment and Nerve Blockade

“…In cadavers, real-time transcricothyroid ultrasonography had high sensitivity (97%) and specificity (100%) for detecting esophageal endotracheal tube placement. 27 In another study, all of 5 patients with esophageal tube placement were identified as having such using transtracheal ultrasonography. 28 The correct placement of a double-lumen tube 29 and laryngeal mask airway (if filled with water) 25 have also been described.…”

“…This "snow storm" does not appear on esophageal intubation, and there may also be the appearance of movement posterior to the 2 laryngeal lines. 27 Static imaging after intubation has shown to be far inferior to dynamic (real-time) imaging for detecting esophageal intubation. 27 Transverse scanning with the probe placed at a 45 angle over the cricothyroid membrane results in an image of a curved thyroid cartilage superficially with the carotid arteries and internal jugular veins on either side.…”

“…27 Static imaging after intubation has shown to be far inferior to dynamic (real-time) imaging for detecting esophageal intubation. 27 Transverse scanning with the probe placed at a 45 angle over the cricothyroid membrane results in an image of a curved thyroid cartilage superficially with the carotid arteries and internal jugular veins on either side. 28 Esophageal intubation produces a striking image with a clearly visible curved hyperechoic line with distal shadowing.…”

An intoxicated man with facial trauma

“…We can prepare and gather all of the necessary equipment, and we can attempt to palpate relevant structures through the skin. We can even use ultrasound to identify peri-laryngeal structures [3]. Draw on his neck with a pen and prepare the skin in advance.…”