Point-of-care ultrasound utilizations in the emergency airway management: An evidence-based review

Pourmand, Ali; Lee, Danny; Davis, Steven; Dorwart, Kelsey; Shokoohi, Hamid

doi:10.1016/j.ajem.2017.02.032

Cited by 9 publications

(8 citation statements)

References 38 publications

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“…Ultrasonography is used in patients with trauma or critical illnesses for vascular assessment, diagnosis, regional anesthesia, and airway management. Ultrasonography for airway management can be performed in the pre-intubation phase to evaluate the pathology and measure the trachea width to estimate the tube size, [6][7][8] intubation phase which detect endotracheal in situ faster than lung auscultation or end tidal CO 2 monitoring, 9,10 and extubation phase to measure diaphragm excusion and predict the extubation success. 11 However, the technique of using ultrasonography for airway assessment is new, and only a few experts use ultrasonography for airway assessment in Thailand.…”

Section: Introductionmentioning

confidence: 99%

Improvement in Validity and Reliability of Airway Assessment Using Ultrasonography by Novice Personnel: A Learning Cohort Study

Prathep¹,

Sikarettrakul²,

Nimmaanrat³

et al. 2022

AMEP

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Purpose To assess improvements in the validity and reliability of novices’ skills in performing ultrasonography for airway assessment. Patients and Methods A learning cohort study was conducted with 20 anesthesiology residents and 10 volunteers in the Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University. The four parameters of airway assessment were soft tissue thickness at the level of 1) hyoid bone (STT-HY), 2) true vocal cords (STT-VC), 3) thyroid isthmus (STT-TI), and 4) suprasternal notch (STT-SN). The magnitude of discrepancies between the residents’ and experienced anesthesiologists’ measurements was evaluated over the sequence of measurements in the 10 volunteers. Results The mean ultrasonic measurements of STT-HY by the experienced anesthesiologists and residents were significantly different (11.09 ± 3.14 mm vs 8.53 ± 3.02 mm, respectively; P = 0.008), whereas measurements of STT-VC, STT-TI, and STT-SN were not (7.18 ± 1.70 vs 7.14 ± 1.93, P = 0.32; 7.81 ± 2.14 vs 7.73 ± 2.19, P = 0.62; and 11.32 ± 3.33 vs 10.30 ± 3.02, P = 0.35, respectively). The mean discrepancy between the residents’ and experienced anesthesiologists’ measurements was close to zero throughout the sequence of measurements of STT-TI and STT-VC. However, the residents’ measurements of STT-HY and STT-SN were considerably lower than those of anesthesiologists. The range of discrepancies between residents and experienced anesthesiologists in each sequential measurement was wide for all measurements, particularly for the measurement values of STT-HY, and the standard deviation of the discrepancies did not decrease over the sequence of measurements. Conclusion Over the sequence of measurements for airway assessment in 10 volunteers by 20 residents in this learning trial, we found no evidence of improvement in measurement accuracy. Discrepancies between the residents’ and anesthesiologists’ measurements and the variability in discrepancy across residents were greatest in the measurement of STT-HY.

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Section: Introductionmentioning

confidence: 99%

Improvement in Validity and Reliability of Airway Assessment Using Ultrasonography by Novice Personnel: A Learning Cohort Study

Prathep¹,

Sikarettrakul²,

Nimmaanrat³

et al. 2022

AMEP

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“…Ultrasonography (US) machines are available in most modern operating theatres and emergency departments. As US is non-irradiating, reproducible, inexpensive and easy to perform, 6 a growing number of anaesthesiologists are using US in a variety of applications in daily practice, especially in airway evaluation. US can be used to estimate the required tracheal tube size, confirm the correct position of the tracheal tube and laryngeal mask, diagnose upper airway pathology, guide percutaneous tracheostomy or cricothyroidotomy and predict post-extubation stridor.…”

Section: Introductionmentioning

confidence: 99%

Application of the new ‘XU-line’ in the dynamic ultrasonographic evaluation of the spatial displacement of anterior cervical tissues for airway management: protocol for a prospective observational study

et al. 2022

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IntroductionPatients with cervical spondylosis have a high incidence of difficult airway, and unpredicted difficult intubation may be life-threatening. Traditional predictors and imaging data may suggest a difficult airway, but these data have limited predictive value, with low sensitivity and specificity. Ultrasonography is a non-irradiating, reproducible, inexpensive and simple tool that provides good imaging of the cervical soft tissue for airway assessment. This study will use the new ‘XU-line’ in the dynamic ultrasonographic airway evaluation of the spatial displacement of the anterior cervical tissues to determine whether preoperative ultrasonographic assessment of the neck anatomy can predict difficult airway.Methods and analysisThis prospective, observational study will be conducted in a single centre. Four hundred and eleven patients scheduled for anterior cervical decompression and fusion under general anaesthesia will be recruited. The parallel trunk reference line through the mentum is defined as the XU-line, and the spatial displacement of the anterior cervical soft tissue relative to the XU-line at six anatomical levels in the transverse plane and two distances in the sagittal plane will be measured on ultrasonography with the patient in the supine position and the sniff position. The spatial displacement distances of soft tissue structures relative to the XU-line will be compared between the ‘easy intubation’ and ‘difficult intubation’ groups (in accordance with the Cormack-Lehane classification). Receiver operating characteristic curves will be used to determine the sensitivity and specificity of the ‘difficulty prediction capability’ of each ultrasonographic and physical measurement. Multiple logistic regression analysis will be performed to determine the independent predictors of difficult intubation.Ethics and disseminationEthical approval for this study has been obtained from the Peking University Third Hospital Medical Science Research Ethics Committee. The results of this study will be disseminated via a peer-reviewed publication and national and international conferences and workshops.Trial registration numberChiCTR2000034446.

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“…[4] Additionally, ultrasound can be rapidly performed, easily portable, and does not have the risk of radiation. [14][15][16] To date, no studies have comprehensively evaluated the literature on hand fractures using ultrasound. Furthermore, data concerning the diagnostic value of ultrasound are variable.…”

Section: Introductionmentioning

confidence: 99%

The value of ultrasound for detecting hand fractures

Zhao¹,

Wang²,

Chen

et al. 2019

Medicine

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Backgrounds: Hand fractures are the second most common upper-extremity fractures. The standard X-ray has shortcomings, such as exposure to radiation. Ultrasound has been reported as an alternative method of detecting hand fractures. In this study, we used meta-analysis to assess the diagnostic value of ultrasound for hand fractures.Methods: Web of Science, PubMed, Embase, and Cochrane Library databases were searched for relative citations up to June 2019. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under the summary receiver operating characteristic curve (AUC), and summary receiver operating characteristic (SROC) curve were estimated.Results: Seven studies including 842 participants (845 examined hands) met our inclusion criteria. The pooled sensitivity, specificity, PLR, and NLR of ultrasound for detecting hand fractures were 91%, 96%, 20.66, and 0.09, respectively. The pooled DOR was 231.17, indicating a very powerful diagnostic ability of ultrasound. Meta-regression showed that there was no heterogeneity with respect to age, cut-off, the performer of the ultrasound, and the types of hand fractures.Conclusions: Our results showed that ultrasound had an excellent diagnostic value for hand fractures. In clinic, we proposed using ultrasound as a first-line and radiation-free modality in detecting hand fractures, including phalanx and metacarpal fractures.Abbreviations: 95% CI = 95% confidence interval, AUC = area under the summary receiver operating characteristic curve, DOR = diagnostic odds ratio, NLR = negative likelihood ratio, PLR = positive likelihood ratio, QUADAS-2 = Quality Assessment of Diagnostic Accuracy Studies tool-2, SROC = summary receiver operating characteristic.

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Point-of-care ultrasound utilizations in the emergency airway management: An evidence-based review

Cited by 9 publications

References 38 publications

Improvement in Validity and Reliability of Airway Assessment Using Ultrasonography by Novice Personnel: A Learning Cohort Study

Improvement in Validity and Reliability of Airway Assessment Using Ultrasonography by Novice Personnel: A Learning Cohort Study

Application of the new ‘XU-line’ in the dynamic ultrasonographic evaluation of the spatial displacement of anterior cervical tissues for airway management: protocol for a prospective observational study

The value of ultrasound for detecting hand fractures

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