Objective: Confirming correct endotracheal tube (ETT) placement is a key component of successful airway management. Ultrasound (US) as a tool for the confirmation of ETT placement has been investigated in the hospital setting but not in the pre-hospital setting. We hypothesized that after a short educational session, military flight medic trainees would be able to accurately identify ETT placement in a cadaver model.
Methods: We conducted a prospective, randomized trial in a human cadaver model. Participants received a brief didactic and hands-on presentation on airway US techniques. Each participant then performed transtracheal US on cadaver models which were randomly assigned to tracheal or esophageal intubation; time to verbalize ETT location was also recorded. Participants were then asked whether they felt airway US would be a useful adjunctive skill in their practice.
Results: Thirty-two military flight medic trainees were enrolled. US had a sensitivity of 66.7% and a specificity of 76.4% for identification of esophageal intubations. The positive predictive value was 71.4% and the negative predictive value was 72.2%. Mean time to report ETT placement was 47.3s. Time did not vary between medics with accurate identification versus inaccurate identification (p=0.176). 83% of participants felt airway US would be a useful adjunctive skill for the confirmation of ETT placement.
Conclusions: Military flight medic trainees can rapidly use airway US to identify ETT placement after a short educational session with moderate sensitivity and specificity. These advanced military medics are interested in learning and implementing this skill into their practice.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ajem.2018.01.074 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Long-term success and survival of post-endodontic restorations without posts after up to 18 years: A practice-based study.
J Dent
January 2025
Department of Restorative, Preventive and Pediatric Dentistry, Zmk Bern, University of Bern, Switzerland; Unit for Practice-Based Research, School of Dental Medicine, University of Bern, Switzerland. Electronic address:
Objectives: The aim of this non-interventional, multi-center, prospective, practice-based study was, firstly, to evaluate the longevity of composite build-ups in endodontically treated teeth, treated with root canal therapy (ETT), without post placement and secondly, to identify and analyze factors influencing the success of these reconstructions.
Methods: Each of seven general dental practitioners placed up to 50 composite build-ups without additional posts in ETT. Teeth were restricted to incisors, canines and premolars.
Comparison of core temperature using tracheal thermometer and pulmonary artery catheter in adult patients undergoing coronary artery bypass graft surgery.
PLoS One
January 2025
Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Background: Monitoring core temperature is important for patients under anesthesia. Esophageal and pulmonary artery blood temperatures can be used for measuring core temperature during general anesthesia. However, these methods pose challenges, especially when the placement of an esophageal thermometer and pulmonary artery catheter (PAC) is either impractical or not the preferred approach.
View Article and Find Full Text PDFComparison of Inspiration-Synchronized and Continuous Vibrating Mesh Nebulizer During Adult Invasive Mechanical Ventilation.
J Aerosol Med Pulm Drug Deliv
December 2024
Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University, Chicago, Illinois, USA.
Aerosol delivery may be enhanced by utilizing an inspiration-synchronized nebulization mode, where nebulization occurs only during inspiration. This study aimed to compare aerosol delivery of albuterol via a prototype of an inspiration-synchronized vibrating mesh nebulizer (VMN) versus continuous VMN during invasive mechanical ventilation. A critical care ventilator equipped with a heated-wire circuit to deliver adult parameters was attached to an endotracheal tube (ETT), a collection filter, and a test lung.
View Article and Find Full Text PDFNeonatal Airway Management and Outcomes Following Fetoscopic Endoluminal Tracheal Occlusion (FETO): A Single-Center Descriptive Analysis.
J Surg Res
December 2024
Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital and Baylor, College of Medicine, Houston, Texas; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas. Electronic address:
Article Synopsis
- Congenital diaphragmatic hernia is a serious condition that can lead to issues like underdeveloped lungs and high blood pressure, but a procedure called fetoscopic endoluminal tracheal occlusion (FETO) has shown to improve patient survival despite some complications like tracheomegaly (enlarged trachea).
- A study analyzed 34 patients who underwent FETO, finding that tracheomegaly was present in 24 of them, with most needing intubation right after birth, some requiring a transition to cuffed endotracheal tubes (ETTs) due to concerns like air leaks.
- The findings suggest that larger or cuffed ETTs may be more beneficial for
Realtime and noninvasive assessment of endotracheal tube displacement using near-infrared and visible cameras.
Biomed Opt Express
November 2024
Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA.
Endotracheal tube (ETT) intubation is a medical procedure routinely used for achieving mechanical ventilation in critically ill patients. Appropriate ETT placement is crucial as undetected tube migration may cause multiple complications or even fatalities. Therefore, prompt detection of unplanned movement of the ETT and immediate action to restore proper placement are essential to ensure patient safety.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!