Endotracheal Tube Verification Via Ultrasound

I think I’ve discovered the new paradigm of research in ultrasound.  Every time you do a procedure or make a diagnosis, slap the ultrasound on someone and see if you can reliably identify anatomic changes.

It looks like, with their practiced ultrasonographers, that they can get some preliminary information regarding endotracheal tube placement by performing transtracheal ultrasound.  Their “gold standard” was waveform capnography – which is a fair gold standard, but not universally sensitive and specific for tube placement in all clinical situations.  Essentially, if the ETT is in the correct place, there is only one “air-mucosal interface” observed with high-frequency linear probe, and, if the ETT is in the esophagus, you have a second, posterior air-mucosal interface.

Seems reasonable.

Experts did it correctly with 99% sensitivity and 94% specificity, and the main advantage was speed.

“Tracheal rapid ultrasound exam (T.R.U.E.) for confirming endotracheal tube
placement during emergency intubation.”