• Hamid Zamani Moghadam, Mohamad Davood Sharifi, Hasan Rajabi, Mojtaba Mousavi Bazaz, Ali Alamdaran, Niazmohammad Jafari, Seyed Amir Masoud Hashemian, and Talebi DeloeiMortezaMDepartment of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran..
• Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
• Emerg (Tehran). 2017 Jan 1; 5 (1): e19.

IntroductionConfirmation of proper endotracheal tube placement is one of the most important and lifesaving issues of tracheal intubation. The present study was aimed to evaluate the accuracy of tracheal ultrasonography by emergency residents in this regard.MethodThis was a prospective, cross sectional study for evaluating the diagnostic accuracy of ultrasonography in endotracheal tube placement confirmation compared to a combination of 4 clinical confirmation methods of chest and epigastric auscultation, direct laryngoscopy, aspiration of the tube, and pulse oximetry (as reference test).Results150 patients with the mean age of 58.52 ± 1.73 years were included (56.6% male). Sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratio of tracheal ultrasonography in endotracheal tube confirmation were 96 (95% CI: 92-99), 88 (95% CI: 62-97), 98 (95% CI: 94-99), 78 (95% CI: 53-93), 64 (95% CI: 16-255), and 0.2 (95% CI: 0.1-0.6), respectively.ConclusionThe present study showed that tracheal ultrasonography by trained emergency medicine residents had excellent sensitivity (>90%) and good specificity (80-90) for confirming endotracheal tube placement. Therefore, it seems that ultrasonography is a proper screening tool in determining endotracheal tube placement.

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