Case Resolution
You directly visualize passage of the ETT through the vocal cords on video laryngoscopy. Waveform capnography confirms an appropriate ETT placement. POCUS is then placed on the neck and also confirms correct tube placement.
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ACEP Now: Vol 38 – No 05 – May 2019Thank you to Chip Lange, an emergency medicine physician assistant and creator of the blog/podcast TOTAL EM and the educational company Practical POCUS.
Remember to be skeptical of anything you learn, even if you heard it on the Skeptics’ Guide to Emergency Medicine.
References
- Takeda T, Tanigawa K, Tanaka H, et al. The assessment of three methods to verify tracheal tube placement in the emergency setting. Resuscitation. 2003;56(2):153-157.
- Tanigawa K, Takeda T, Goto E, et al. Accuracy and reliability of the self-inflating bulb to verify tracheal intubation in out-of-hospital cardiac arrest patients. Anesthesiology. 2000:93(6);1432-1436.
- Tanigawa K, Takeda T, Goto E, et al. The efficacy of esophageal detector devices in verifying tracheal tube placement: a randomized cross-over study of out-of-hospital cardiac arrest patients. Anesth Analg. 2001;92(2):375-378.
- Brown CA 3rd, Bair AE, Pallin DJ, et al. Techniques, success, and adverse events of emergency department adult intubations. Ann Emerg Med. 2015;65(4):363-370.
- Bache S, Pfeiffer P, Rudolph SS, et al. Temporal comparison of ultrasound versus auscultation and capnography in verification of endotracheal tube placement in obese patients. Br J Anaesth. 2012;108(S2):ii118.
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