title: Tracheal ultrasonography and ultrasonographic lung sliding for confirming endotracheal tube placement: Speed and Reliability.
abstract: BACKGROUND
  In this study we aimed to evaluate the success of ultrasonography (USG) for confirming the tube placement and timeliness by tracheal USG and ultrasonographic lung sliding in resuscitation and rapid sequence intubation.
  
  
  METHODS
  This study was a prospective, single-center, observational study conducted in the emergency department of a tertiary care hospital. Patients were prospectively enrolled in the study. Patients who went under emergency intubation because of respiratory failure, cardiac arrest or severe trauma included in the study. Patients with severe neck trauma, neck tumors, history of neck operation or tracheotomy and under 18years old were excluded from the study.
  
  
  RESULTS
  A total of 115 patients included in the study. The mean age was 67.2±17.1 with age 16-95years old. Among 115 patients 30 were cardiac arrest patients other 85 patients were non-cardiac arrest patients intubated with rapid sequence intubation. The overall accuracy of the ultrasonography was 97.18% (95% CI, 90.19-99.66%), and the value of kappa was 0.869 (95% CI, 0.77-0.96), indicating a high degree of agreement between the ultrasonography and capnography. The ulrasonography took significantly less time than capnography in total.
  
  
  CONCLUSIONS
  Ultrasonography achieved high sensitivity and specificity for confirming tube placement and results faster than end-tidal carbon dioxide. Ultrasonography is a good alternative for confirming the endotracheal tube placement. Future studies should examine the use of ultrasonography as a method for real-time assessment of endotracheal tube placement by emergency physicians with only basic ultrasonographic training.
authors.affiliation: Bozok University Faculty of Medicine EM Dept, Yozgat, Turkey. Electronic address: karacabeysinan@yahoo.com.
authors.forename: Sinan
authors.initials: S
authors.lastname: Karacabey
authors.affiliation: Sultanbeyli State Hospital EM Dept, Istanbul, Turkey. Electronic address: Erkman00@gmail.com.
authors.forename: Erkman
authors.initials: E
authors.lastname: Sanrı
authors.affiliation: Kartal Dr Lutfi Kırdar Training and Research Hospital EM Dept, Istanbul, Turkey. Electronic address: dr.gokhangencer@gmail.com.
authors.forename: Emin Gokhan
authors.initials: EG
authors.lastname: Gencer
authors.affiliation: Kartal Dr Lutfi Kırdar Training and Research Hospital EM Dept, Istanbul, Turkey. Electronic address: guneysel@gmail.com.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Guneysel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D014463:Ultrasonography; D055815:Young Adult