Comparison of Upper Airway Ultrasonography with Standard Waveform Capnography and Auscultation to Verify Correct Placement of Endotracheal Tube after Intubation
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 9
Abstract
Introduction: Verification of correct endotracheal tube (ETT) placement and avoidance of esophageal, endobrocheal intubation has important implications. Ultrasonography (USG) is an indispensible method in ETT position confirmation. It is reliable and easily available. Ultrasound (US) is an accessible tool with reproducible results, inexpensible and pain free. Also there are no harmful effects on the patient and thus ethically justified. Material and methods: The probe is placed horizontally starting from cricothyroid membrane upto suprasternal notch and then given a slight 30° tilt to left (also to right) to rule out esophageal intubation. The esophagus will be empty on USG in case of tracheal intubation. Results: ETT placement came out to be 98.5%. Our ĸ value came out to be 0.92. Thus upper airway sonography is in very good correlation with waveform capnography in correct tracheal tube confirmation. CONCLUSION- Upper airway USG can replace endtidal carbon dioxide (ETCO2) monitoring as the gold standard modality in verification of correct endotracheal intubation. With adequate experience and future reserch on this topic covering a larger population and varied working environment, USG can emerge as the primary modality as the ‘point of care’ for confirming endotracheal intubation even in emergency situations.
Authors and Affiliations
Priyanka Bansal
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