응급의료센터에서 기관 내관의 위치 확인 시 초음파의 유용성 = The Availability of Bedside Ultras-onography in Confirming Endotracheal TubePlacement in the Emergency Department

다국어 초록 (Multilingual Abstract)

Purpose: The goal of this study was to determine the suitability
of ultrasonography for detecting endotracheal tube
placement in the emergency department.
Methods: Emergency physicians examined patients immediately
following intubation or after intubated patients were
transferred. A linear ultrasound transducer was placed
transversely on the cricothyroid membrane and suprasternal
notch in order to check for the “comet head and tail
sign”and “double ring sign”, and a sagittal view of the
neck was also obtained in order to look for the “bold parallel
lines sign”. Subsequently, simple thoracic sonography and
color doppler sonography were used to check for the “lung
sliding sign”. The examiner evaluated whether the tube
was placed in trachea, the esophagus, or the right main
bronchus. The accuracy of ultrasonography was calculated,
and the required time for ultrasonography was checked.
Results: One hundred ten patients were enrolled in the
study. The endotracheal tube was placed in the trachea in
107 patients, in the esophagus in 2 patients, and in the right
main bronchus in 1 patient. The sensitivity and specificity of
ultrasonography were 100%. The bold parallel lines sign
and lung sliding sign proved to be good indicators of endotracheal
tube placement. The average required time for
ultrasonography was 28.6±5.8 seconds. It was difficult to
determine tube placement by thoracic ultrasonography in
patients with pneumothorax, hemothorax, pleural effusion,
or empyema.
Conclusion: Ultrasonography is well suited for confirming
endotracheal tube placement in the emergency department.

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