title: 2-point ultrasonography to confirm correct position of the gastric tube in prehospital setting.
abstract: X-ray remains the "gold standard" test to control the gastric tube (GT) position. The aim of this study is to estimate the diagnostic accuracy of a 2-point ultrasonography to confirm GT placement in the prehospital setting.
  
  
  METHODS
  The emergency physician performed an ultrasound examination during GT insertion. The aim was to determine whether or not the GT could be viewed in the esophagus and/or in the stomach.
  
  
  RESULTS
  Thirty-two intubated patients were included. In 100% of cases, the GT was instantly identified by ultrasound at esophagus and in 62.5% at stomach. In 6 cases, the GT was not seen in the stomach, but the injection of air through the GT allowed to confirm intragastric position in 2 cases. In the 4 other cases, no dynamic fogging was observed. In hospital X-ray control confirmed the correct positioning of 28/32.
  
  
  CONCLUSIONS
  The 2-point ultrasonographic live control of the GT position has a better sensitivity and a much higher specificity than the syringe test but similar to the xiphoid ultrasound control. However, our method allows to show the GT in the esophagus and to use the dynamic ultrasound fogging to reveal an intragastric position that was not obvious with the common techniques.
authors.affiliation: Department of Emergency Medicine and Intensive Care, Desgenettes Military Hospital, Lyon, France.
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Brun
authors.affiliation: Prehospital Emergency Medical Services of Marine Fire Battalion, Marseille, France.
authors.forename: Hichem
authors.initials: H
authors.lastname: Chenaitia
authors.affiliation: Department of Emergency Medicine and Intensive Care, Desgenettes Military Hospital, Lyon, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Lablanche
authors.affiliation: Prehospital Emergency Medical Services of Marine Fire Battalion, Marseille, France.
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Pradel
authors.affiliation: Prehospital Emergency Medical Services of Marine Fire Battalion, Marseille, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Deniel
authors.affiliation: Prehospital Emergency Medical Services of Marine Fire Battalion, Marseille, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Bessereau
authors.affiliation: Prehospital Emergency Medical Services of Marine Fire Battalion, Marseille, France.
authors.forename: Régis
authors.initials: R
authors.lastname: Melaine
mesh_terms: D004632:Emergency Medical Services; D004638:Emergency Treatment; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013270:Stomach / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional