Differences Between Esophageal and Tracheal Intubation Ultrasound View Proficiency: An Educational Study of Novice Prehospital Providers

Curēus
Ann KaminskiLeslie V Simon

Abstract

Objectives Airway ultrasound is now possible in the prehospital setting due to advances in ultrasound equipment portability. We questioned how well prehospital providers without prior experience could determine both esophageal and tracheal placement of an endotracheal tube in cadavers after a brief training course in ultrasound.  Methods This educational prospective study at the Simulation Center in Mayo Clinic Jacksonville Florida enrolled 50 prehospital providers. Demographic and practice background information was obtained through surveys. Each participant performed a baseline ultrasound to determine endotracheal tube placement in a cadaver that was randomly assigned to an esophageal or tracheal intubation. Participants then repeated the randomized testing after a 15-minute tutorial. Before and after overall accuracy as well as proportions of correct identification of esophageal and tracheal intubations were determined and compared using standard binomial proportion and McNemar's tests. Results  None of the participants had prior experience of performing airway ultrasound. Baseline group scores were 60% (CI 45%-74%) for overall accuracy (n=50), 55% (CI 32%-76%) for correct identification of an esophageal intubation, and 64% ...Continue Reading

References

Feb 1, 1997·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·S J White, C M Slovis
May 15, 2007·The Journal of Emergency Medicine·Truman John MillingJoseph SchianodiCola
Jul 1, 2015·Critical Ultrasound Journal·Sachita ShahDana Sajed
Feb 27, 2018·The American Journal of Emergency Medicine·Erin R HanlinKenton L Anderson
Aug 19, 2018·Annals of Emergency Medicine·Michael GottliebGary D Peksa
Aug 22, 2018·Prehospital and Disaster Medicine·Penelope C LemaBrian Clemency

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