Abstract

Objective: To determine the fastest technique (chest auscultation or upper airway ultrasonography) for confirming endotracheal tube placement in critically ill patients.
Methodology: This cross-sectional study included 110 critically ill patients of age >18 years who requires endotracheal intubation and were selected from emergency department of Ziauddin University Hospital (North Campus) Karachi by using non-probability consecutive sampling technique. 110 patients of ASA grade E were envaulted clinically and position of endotracheal tube was confirmed on chest auscultation (breath sounds presence) and upper airway ultrasonography (presence of lung sliding sign). Time required for both techniques was recorded.
Results: Endotracheal tube placement was 100.0% in critically ill patients; of which male were 60.0% and female were 40.0% having mean age of 55.21±16.66 years. Respiratory failure (62.7%) was the most common presentation in critically ill patients followed by heart failure (16.4%), renal failure (16.4%), low Glasgow Coma Scale (GCS; 6.4%) and cerebrovascular accident (CVA; 4.5%). Endotracheal tube placement confirmation was more rapid in upper airway ultrasonography (7.40±2.31 seconds) as compared to chest auscultation (10.34±2.75 seconds).
Conclusion: Confirmation of endotracheal tube placement was faster with upper airway ultrasonography than with chest auscultation.

Key words: Endotracheal tube, auscultation, ultrasonography, intubation, emergency,critically ill.