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ID Design 2012/DOOEL Skopje, Republic of Macedonia

Open Access Macedonian Journal of Medical Sciences.

https://doi.org/10.3889/oamjms.2017.072

eISSN: 1857-9655

Clinical Science

 

 

 

Predictive Value of Tracheal Rapid Ultrasound Exam Performed in the Emergency Department for Verification of Tracheal Intubation


 

Babak Masoumi1, Reza Azizkhani1, Gilava Hedayati Emam2, Morteza Asgarzadeh3, Behrouz Zargar Kharazi1*

 

1Department of Emergency Medicine, Emergency Medicine Research Center, Al-Zahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; 2Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Chief Research Fellow, Harvard University, T.H. Chan School of Public Health, Massachusetts, USA

 

Abstract

 

 

BACKGROUND: Verification of the correct placement of the endotracheal tube (ETT) has been one of the most challenging issues of airway management in the field of emergency medicine. Early detection of oesophagal intubation through a reliable method is important for emergency physicians.

AIM: The aim of this study was to assess the diagnostic accuracy of tracheal rapid ultrasound exam (TRUE) to assess endotracheal tube misplacement during emergency intubation.

METHODS: This was an observational prospective study performed in the emergency department of the major tertiary referral hospital in the city. We included a consecutive selection of 100 patients. TRUE was performed for all these patients, and subsequently, quantitative waveform capnography was done. The later test is considered as the gold standard.

RESULTS: From our total 100 eligible patients, 93 (93%) participants had positive TRUE results (tracheal intubation) and 7 (7%) patients have negative TRUE results (esophageal intubation). Quantitative waveform capnography report of all 93 (100%) patients who had positive TRUE was positive (appropriate tracheal placement). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TRUE for detecting appropriate tracheal placement of ETT were 98.9% (95% CI, 93.3% to 99.8%), 100% (95% CI, 51.6% to 100%), 100% (95% CI, 95.1% to 100%) and 85.7% (95% CI, 42% to 99.2%) respectively.

CONCLUSIONS: Performing TRUE is convenient and feasible in many emergency departments and pre-hospital settings. We would recommend emergency units explore the possibility of using TRUE as a method in the assessment of proper ETT placement.

..................

Citation: Masoumi B, Azizkhani R, Emam GH, Asgarzadeh M, Kharazi BZ. Predictive Value of Tracheal Rapid Ultrasound Exam Performed in the Emergency Department for Verification of Tracheal Intubation. Open Access Maced J Med Sci. https://doi.org/10.3889/oamjms.2017.072
Keywords: trachea; ultrasonography; intubation; emergencies.
*Correspondence: Behrouz Zargar Kharazi, Department of Emergency Medicine, Emergency Medicine Research Center, Al-Zahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-9131172956, E-mail: behrooz_zargar@yahoo.com
Received: 12-Mar-2017; Revised: 04-Apr-2017; Accepted: 18-Apr-2017; Online first: 17-Jun-2017
Copyright: 2017 Babak Masoumi, Reza Azizkhani, Gilava Hedayati Emam, Morteza Asgarzadeh, Behrouz Zargar Kharazi. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
Funding: This research did not receive any financial support.
Competing Interests: Publication of this paper has been supported by Roche Macedonia DOOEL Skopje.
 

 

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Published by: Id Design 2012/DOOEL Skopje, Republic of Macedonia


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.