जर्नल ऑफ़ मॉलिक्यूलर इमेजिंग एंड डायनेमिक्स
खुला एक्सेस

अमूर्त

Verification of Endotracheal Intubation with Ultrasonography in Emergency Medicine Clinic

Mustafa K, Gokhan Y, Suha S, Bahadır C and Ismet P

Introduction and Aim: Endotracheal intubation (EI) is vital in emergency medicine where airway management is critical. In literature haven't got any gold standard method for endotracheal tube (ET) confirmation. Aim of our study is to compare sensitivity and specificity of ultrasonography (USG) that has become widespread in emergency medicine, in confirmation of ET with other methods. Materials and Methods: This study is a clinical observational prospective single-centered and conducted at Emergency Department of Ä°zmir Bozyaka Training and Research Hospital in September – November 2014. All the patient above 18 years old who had been intubated because of medical indications and cardiac arrest are included. End-tidal waveform capnograph and oscultation were used. We used Ultrasonography (USG) just after incubation for confirmation of tube placement. During ventilation, both hemithorax and epigastric area were auscultated. Simultaneously, we used USG for lung sliding bilaterally. After six ventilations, we recorded value of partial pressure of carbon dioxide (pCO2) on capnograph and whether waveform was present, or not. Results: 37 patients were included to the study. 19 (51.4%) were men. 21 (56.8%) of the patient were intubated due to cardiac arrest, 2 (5.4%) of them due to low Glasgow coma scale (GCS), 12 (32.4%) of them too difficult intubation, 1 (2.7%) of them due to low partial pressure of oxygen (pO2), 1 (2.7%) of them to change ET. Sensitivity of USG for confirmation of tube placement is 100% (CI 95%; 40.23-100%), specificity is 96.97% (95%CI; 84.18-99.49%), positive predictive value (PPV) 80% (CI 95%; 28.81-96.70%), negative predictive value (NPV) 100% (CI 95%; 89.01-100%). Kappa value of USG is 0,87. Conclusion: USG is being largely used in emergency departments and shows high sensitivity and specificity to confirm ET placement. USG can be used to confirm endotracheal tube placement; so, complications of esophageal intubation can be avoided.