Tracheal rapid ultrasound exam (T.R.U.E.) for confirming endotracheal tube placement during emergency intubation

Chou, Hao-Chang; Tseng, Wen-Pin; Wang, Chih‐Hung; Huei‐Ming, Matthew; Wang, Hsiu-Po; Huang, Edward Pei-Chuan; Sim, Shyh-Shyong; Liao, Yen-Chen; Chen, Shey-Yin; Hsu, Chao-Ming; Yen, Zui-Shen; Chang, Wei‐Tien; Huang, Chien-Hua; Lien, Wan‐Ching; Chen, Shyr‐Chyr

doi:10.1016/j.resuscitation.2011.05.016

Cited by 194 publications

(168 citation statements)

References 30 publications

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“…For the important outcome of detection of correct placement of a tracheal tube during CPR, we identified low-quality evidence (downgraded for suspicion of publication bias and indirectness) from 3 observational studies [51][52][53] including 254 patients in cardiac arrest that evaluated the use of ultrasound to detect tracheal tube placement. The pooled specificity was 90% (95% CI, 68%-98%), the sensitivity was 100% (95% CI, 98%-100%), and the FPR was 0.8% (95% CI, 0.2%-2.6%).…”

Section: Ultrasound For Tracheal Tube Detectionmentioning

confidence: 99%

Part 4: Advanced Life Support

Nolan¹,

Hazinski²,

Aickin³

et al. 2015

Circulation

553

125

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Questions to be addressed (using the PICO [population, intervention, comparator, outcome] format) 3 were prioritized by ALS Task Force members (by voting). Prioritization criteria included awareness of significant new data and new controversies or questions about practice. Questions about topics no longer relevant to contemporary practice or where little new research has occurred were given lower priority. The ALS Task Force prioritized 42 PICO questions for review. With the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk of bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 for studies of diagnostic accuracy, 5 and GRADE for observational studies that inform both therapy and prognosis questions. 6 GRADE evidence profile tables 7 were then created to facilitate an evaluation of the evidence in support of each of the critical and important outcomes. The quality of the evidence (or confidence in the estimate of the effect) was categorized as high, moderate, low, or very low, 8 based on the study methodologies and the 5 core GRADE domains of risk of bias, inconsistency, indirectness, imprecision, and other considerations (including publication bias). 9 These evidence profile tables were then used to create a written summary of evidence for each outcome (the consensus on science statements). Whenever possible, consensus-based treatment recommendations were then created. These recommendations (designated as strong or weak) were accompanied by an overall assessment of the evidence and a statement from the task force about the values, preferences, and task force insights that underlie the recommendations. Further details of the methodology that underpinned the evidence evaluation process are found in "Part 2: Evidence Evaluation and Management of Conflicts of Interest."The task force preselected and ranked outcome measures that were used as consistently as possible for all PICO questions. Longer-term, patient-centered outcomes were considered more important than process variables and shorter-term outcomes. For most questions, we used the following hierarchy starting with the most important: long-term survival with neurologically favorable survival, long-term survival, short-term survival, and process variable. In general, longterm was defined as from hospital discharge to 180 days or longer, and short-term was defined as shorter than to hospital discharge. For certain questions (eg, related to defibrillation or confirmation of tracheal tube position), process variables such as termination of fibrillation and correct tube placement were important. A few questions (eg, organ donation) required unique outcomes....

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Section: Ultrasound For Tracheal Tube Detectionmentioning

confidence: 99%

Part 4: Advanced Life Support

Nolan¹,

Hazinski²,

Aickin³

et al. 2015

Circulation

553

125

View full text Add to dashboard Cite

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“…US has also been used for detecting neoplastic masses or vocal cord inflammation [11][12][13]. Assessment of correct endotracheal tube placement US can show the presence of the endotracheal tube in the trachea [14] either directly or after increasing the echogenicity (by gently moving a stylet inside it or by inflation of the tube cuff using fluid or air bubbles) [15]. In case of esophageal intubation (occurring in 15 % of cases), the endotracheal tube can be visualized directly in the esophagus (on transverse scans posterior to the left lobe of the thyroid) due to the appearance of a second interface, referred to as a ''double airway tract'' in the esophagus, or by gently moving the tube up and down.…”

Section: Us Assessment Of the Airwaymentioning

confidence: 99%

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Sofia

2013

J Ultrasound

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Objectives The aim of this review article is to present the current views and visions of the role of ultrasound (US) in the management of patients with multiple trauma. The article is divided into two parts. Part 1 (US findings and techniques) will mainly deal with the technical aspects of US imaging in trauma patients and is written also for educational purposes. Part 2 (pathophysiology and US imaging in trauma patients) will deal with integration of US in the clinical and pathophysiological management of multiple trauma patients. Methods A non-systematic review of the literature through PubMed search (restricted to the last 10 years) of original articles and review articles. Results 80 publications were selected for Part 1. Of these 80 articles, the author selected 50 according to personal criteria on the basis of their innovative or original contents (48 original articles and 2 literature review articles); 19 articles were furthermore extracted from the references of the selected publications. The information extracted from these 69 publications was organized into sections dealing with different fields of applications of US imaging in multiple trauma patients. Conclusions US imaging in trauma has evolved from the initial use, i.e., early diagnosis of peritoneal effusion (focused abdominal sonography for trauma), to a wider use known as resuscitative ultrasonography, and is today considered as an extension of physical examination to implement a more effective approach to clinical problems and increase the timeliness and safety of interventions. Keywords Trauma Á Ultrasound Á Ultrasound findings Á Ultrasound techniqueRiassunto Obiettivi L'obiettivo di questa ricerca è di presentare la visione e le opinioni correnti sul ruolo dell'ecografia nella gestione del paziente con politrauma. L'articolo è diviso in due parti: nella prima ('Semeiotica ecografica e tecnica di esecuzione dell'esame') verrà data attenzione agli aspetti prevalentemente tecnici dell'ecografia nel trauma, con intento anche didattico; nella seconda (Fisiopatologia e ecografia clinica del trauma) sarà esplorato il tema dell'integrazione dell'ecografia con la clinica e la fisiopatologia nella gestione del politraumatizzato. Metodi Revisione non sistematica della letteratura. Ricerca su PubMed (restrizione agli ultimi 10 anni) di articoli originali e revisioni. Risultati Per la Parte prima sono stati selezionati 80 articoli, tra i quali sono stati scelti con criteri personali quelli ritenuti innovativi o originali nei contenuti (48 articoli originali, 2 revisioni di letteratura). 19 articoli sono stati estratti dalla bibliografia delle pubblicazioni prescelte. I contenuti estratti dai 69 articoli sono stati organizzati in paragrafi intitolati ai singoli ambiti di applicazione dell'ecografia nel politrauma. Conclusioni L'ecografia del trauma è evoluta dalla iniziale applicazione nella diagnosi precoce del versamento peritoneale (Focused Abdominal Sonography for Trauma o FAST) all'accezione più ampia di Resuscitative Ultrasonography (RUS) e v...

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“…If doubt persists, direct view of the tracheal rings by fiberoptic bronchoscopy can be a 'gold standard' to identify the position. Additionally, ultrasound may verify whether the tube is in the trachea (20,21), and indirectly may detect whether a unilateral bronchial intubation exists (22,23).…”

Section: Confirmation Of Endotracheal Intubation Placementmentioning

confidence: 99%

Clinical consensus of emergency airway management

Sun¹,

Ya²,

Shi-cheng³

et al. 2017

J. Thorac. Dis.

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Airway management is a common and key method to maintain and improve external respiration function of patients. Emergency physicians need a more appropriate guide to airway management. We concisely concluded current circumstances of Chinese emergency airway management. Then, we raised four principles: (I) priority to ventilation and oxygenation; (II) evaluation before intubation; (III) higher level of preparation (de-escalation); (IV) simplest (and least potentially harmful) form of intubation. We raised "CHANNEL" flow to direct initial emergency airway management and an algorithm was showed for emergency physicians understanding key points of airway management and further making medical decision.Finally, we introduced pharmacology of airway management.

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Tracheal rapid ultrasound exam (T.R.U.E.) for confirming endotracheal tube placement during emergency intubation

Cited by 194 publications

References 30 publications

Part 4: Advanced Life Support

Part 4: Advanced Life Support

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Clinical consensus of emergency airway management

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