Does Bedside Ultrasound Detect Esophageal Intubation?

End-tidal CO₂ detection is the standard for confirmation of endotracheal tube (ETT) placement. However, CO₂ detection has limited utility in patients with extreme hypotension or cardiac arrest. Results from two studies suggest that an ultrasound technique for visualizing ETT placement through the cricothyroid membrane detects inadvertent esophageal tube placement in circumstances when the usual methods of confirmation can fail.

In a randomized, double-blind study, esophageal and tracheal intubations were performed in a cadaver, and ETT placement was assessed using the ultrasound technique during the intubation process (dynamic technique) and after intubation was completed (static technique). A total of 140 assessments were made. With the dyn…