Airway Sonography in Live Models and Cadavers

Tsui, Ban C. H.; Ip, Vivian; Walji, Anil H.

doi:10.7863/ultra.32.6.1049

Cited by 19 publications

(9 citation statements)

References 13 publications

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“…Although cadaveric ultrasonographic studies reveal useful information on sono‐anatomy and performance of invasive procedures, clinicians utilising cadavers alone are still not able to appreciate the real‐time challenges of laboured respiratory movements, which makes airway ultrasonography a particular challenge in patients with difficult airways. In addition, cadavers have altered tissue handling characteristics .…”

Section: Discussionmentioning

confidence: 99%

A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects

Kristensen

Teoh²,

Rudolph

et al. 2016

Anaesthesia

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A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects SummaryWe compared the transverse and longitudinal approaches to ultrasound-guided identification of the cricothyroid membrane, to determine which was faster and more successful. Forty-two anaesthetists received a one-hour structured training programme consisting of e-learning, a lecture and hands-on training, and then applied both techniques in a randomised, cross-over sequence to obese females with body mass index 39.0 -43.9 kg.m À2. The mean (SD) time to identify the cricothyroid membrane was 24.0 (12.4) s using the transverse technique compared with 37.6 (17.9) s for the longitudinal technique (p = 0.0003). Successful identification of the cricothyroid membrane was achieved by 38 (90%) anaesthetists using either technique. All anaesthetists were successful in identifying the cricothyroid membrane with at least one of the techniques. We advocate the learning and application of these two techniques for identification of the cricothyroid membrane before starting anaesthesia in difficult patients, especially when anatomical landmarks are impalpable. Further use in emergency situations is feasible, if clinicians have experience and the ultrasound machine is readily available.

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Section: Discussionmentioning

confidence: 99%

A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects

Kristensen

Teoh²,

Rudolph

et al. 2016

Anaesthesia

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“…11 However, cadaver tissue often appears different from and lacks the respiratory variations of live human tissue with ultrasound imaging; thus, a cadaver model may not accurately reflect the performance of CDI in confirming ETT placement in live humans. 12,13 In this pilot study, we used video captured from live humans, with either tracheal or esophageal intubations, to evaluate whether CDI can improve correct ETT localization compared to grayscale US using an online assessment of medical professionals. We also investigated whether there is a relationship between the accuracy of US interpretation for this indication and the training level of participants.…”

Section: How Does This Improve Population Health?mentioning

confidence: 99%

The Utility of Color Doppler to Confirm Endotracheal Tube Placement: A Pilot Study

Gildea

Anderson

Niknam

et al. 2020

WestJEM

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Introduction: Grayscale ultrasound (US) imaging has been used as an adjunct for confirming endotracheal tube (ETT) placement in recent years. The addition of color Doppler imaging (CDI) has been proposed to improve identification but has not been well studied. The aim of this study was to assess whether CDI improves correct localization of ETT placement. Methods: A convenience sample of emergency and critical care physicians at various levels of training and experience participated in an online assessment. Participants viewed US video clips of patients, which included either tracheal or esophageal intubations captured in grayscale or with CDI; there were five videos of each for a total of 20 videos. Participants were asked to watch each clip and then assess the location of the ETT. Results: Thirty-eight subjects participated in the online assessment. Levels of training included medical students (13%), emergency medicine (EM) residents (50%), EM attendings (32%), and critical care attendings (5%). The odds ratio of properly assessing tracheal placement using color relative to a grayscale imaging technique was 1.5 (p = 0.21). Regarding the correct assessment of esophageal placement, CDI had 1.4 times the odds of being correctly assessed relative to grayscale (p = 0.26). The relationship between training level and correct assessments was not significant for either tracheal or esophageal placements. Conclusion: In this pilot study we found no significant improvement in correct identification of ETT placement using color Doppler compared to grayscale ultrasound; however, there was a trend toward improvement that might be better elucidated in a larger study. [West J Emerg Med. 2020;21(4)870-875.] due to stomach insufflation. There are multiple methods to confirm correct ETT tube placement that include direct visualization, capnography, visualization of chest rise, and direct auscultation; however, each of these methods has its limitations. 1,2 Quantitative waveform capnography combined

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“…It is important to be aware of the normal sonographic appearance of the cricoid and thyroid cartilage . The cricoid cartilage may be mistaken for a soft tissue mass (Figure and Videos 3 and 4), as the sides of the cricoid ring appear as hypoechoic round or ovoid structures on sagittal views .…”

Section: Normal Structures That May Mimic Diseasementioning

confidence: 99%

Surveillance Neck Sonography After Thyroidectomy for Papillary Thyroid Carcinoma: Pitfalls in the Diagnosis of Locally Recurrent and Metastatic Disease

2017

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A sonographic examination of the neck performed 6 to 12 months after thyroid surgery in patients with differentiated thyroid cancer is strongly recommended by the American Thyroid Association and considered mandatory by the European Thyroid Association for locoregional surveillance. The aim of this article is to review the normal anatomic changes expected after thyroid surgery and the pathologic mimics of thyroid carcinoma recurrence in post-thyroidectomy patients as they appear on neck sonography. We hope to offer some pearls to increase diagnostic confidence in this setting.

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Airway Sonography in Live Models and Cadavers

Cited by 19 publications

References 13 publications

A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects

A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects

The Utility of Color Doppler to Confirm Endotracheal Tube Placement: A Pilot Study

Surveillance Neck Sonography After Thyroidectomy for Papillary Thyroid Carcinoma: Pitfalls in the Diagnosis of Locally Recurrent and Metastatic Disease

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