Ultrasound for Intubation Confirmation: A Randomized Controlled Study Among Emergency Medicine Residents Publisher Pubmed



Hosseinnejad H¹ ; Mehrjerdi MHS¹ ; Abdollahi A¹ ; Loesche MA² ; Schulwolf S² ; Ghadipasha M³ ; Mohammadinejad P⁴ ; Ataeinia B⁵ ; Shokoohi H² Show Affiliations
Source: Ultrasound in Medicine and Biology Published:2021

Abstract

Confirmation of endotracheal tube (ETT) placement during intubation is a critical skill for emergency medicine (EM) residents; airway ultrasonography has been suggested as an accessible and accurate method of ETT confirmation. Here, we investigated the accuracy with which EM residents could identify ETT location in cadavers using different ultrasound modes. EM attendings intubated either the trachea or the esophagus of a cadaver, and blinded residents identified ETT position using either B-mode or B-mode plus color Doppler. Residents correctly identified ETT location in 1075 of 1203 trials (89.4%); performance improved with post-graduate year (residents in post-graduate year 3 had 97.8% accurate identifications). There were 556 (91.7%) correct identifications made with B-mode and 519 (86.9%) with B-mode plus color Doppler (p value = 0.007); thus, accuracy did not improve with addition of color Doppler to B-mode. Further research is needed on the efficacy of different ultrasound modes in confirming ETT placement in live intubations. © 2020 World Federation for Ultrasound in Medicine & Biology