Xth World Academic Congress of Emergency Medicine WACEM 2024 ITALY

Abstract

Endotracheal intubation is a routine procedure in Emergency departments.The gold standard for confirming endotracheal tube (ETT) placement includes 5-point auscultation and continuous waveform capnography, with post-intubation chest radiography serving as gold standard for secondary confirmation.This study evaluates the diagnostic accuracy of point of care ultrasonography (POCUS) in verifying ETT placement as compared to these gold standard methods. Materials and Methods:In this single-centre, descriptive diagnostic test evaluation study conducted over one year, 134 patients were consecutively recruited.After intubation, ETT placement was first confirmed by the treating physician using the gold standard methods.Simultaneously, the investigator assessed ETT placement using ultrasonography of the neck and lungs, followed by a chest X-ray.Diagnostic metrics such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. Results and Conclusion:The study included 134 patients.Ultrasonography of the neck and lungs both demonstrated a diagnostic accuracy of 100%, correctly identifying all cases of tracheal and esophageal intubation.The sensitivity, specificity, PPV and NPV was 100%.Ultrasonography (USG) lung was able to identify all cases of tracheal intubations with ETT position above carina and right bronchus correctly thus having a diagnostic accuracy of 100%.The sensitivity, specificity, PPV and NPV is 100%.The study concluded that POCUS utilizing USG neck and USG lung can be used with 100% diagnostic accuracy in confirming proper placement of ETT.

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