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Inflating the endotracheal tube cuff with saline to confirm correct depth using bedside ultrasonography

Published online by Cambridge University Press:  11 February 2015

Mark O. Tessaro ,
Alexander C. Arroyo ,
Lawrence E. Haines  and
Eitan Dickman
Mark O. Tessaro*
Affiliation:
Division of Emergency Ultrasound, Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY
Alexander C. Arroyo
Affiliation:
Division of Emergency Ultrasound, Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY
Lawrence E. Haines
Affiliation:
Division of Emergency Ultrasound, Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY
Eitan Dickman
Affiliation:
Division of Emergency Ultrasound, Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY
*
Correspondence to: Dr. Mark Tessaro, Department of Emergency Medicine, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219; MTessaro@maimonidesmed.org

Abstract

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Although bedside ultrasonography can accurately distinguish esophageal from tracheal intubation, it is not used to establish the correct depth of endotracheal tube insertion. As indirect sonographic markers of endotracheal tube insertion depth have proven unreliable, a method for visual verification of correct tube depth would be ideal. We describe the use of saline to inflate the endotracheal cuff to confirm correct endotracheal tube depth (at the level of the suprasternal notch) by bedside ultrasonography during resuscitation. This rapid technique holds promise during emergency intubation.

Résumé

Bien que l’é chographie au chevet des patients permette de distinguer nettement l’intubation oesophagienne de l’intubation endotrachéale, elle n’est toutefois pas utilisée pour déterminer si la sonde a été posée à la bonne profondeur dans la trachée. Comme on ne peut se fier aux marqueurs échographiques indirects de vérification de la profondeur de pénétration de la sonde endotrachéale, l’idéal serait de procéder par vérification visuelle. II sera question ici du gonflement du ballonnet endotrachéal avec une solution saline pour confirmer l’introduction de la sonde à la bonne profondeur (à la hauteur de la fourchette sternale) par échographie au chevet des patients durant les manoeuvres de réanimation. Cette technique rapide se révèle prometteuse dans le contexte des intubations d’urgence.

Keywords

bedside ultrasonographyendotracheal tubeintubation
Type
Case Report
Information
Canadian Journal of Emergency Medicine , Volume 17 , Issue 1 , January 2015 , pp. 94 - 98
Copyright
Copyright © Canadian Association of Emergency Physicians 2014 

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