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.
Key Words
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Article info
Publication history
Published online: November 17, 2020
Accepted:
October 17,
2020
Received in revised form:
October 13,
2020
Received:
June 23,
2020
Identification
Copyright
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