title: Screening Characteristics of Bedside Ultrasonography in Confirming Endotracheal Tube Placement; a Diagnostic Accuracy Study.
abstract: BACKGROUND
  Confirmation of proper endotracheal tube placement is one of the most important and lifesaving issues of tracheal intubation. The present study was aimed to evaluate the accuracy of tracheal ultrasonography by emergency residents in this regard.
  
  
  METHODS
  This was a prospective, cross sectional study for evaluating the diagnostic accuracy of ultrasonography in endotracheal tube placement confirmation compared to a combination of 4 clinical confirmation methods of chest and epigastric auscultation, direct laryngoscopy, aspiration of the tube, and pulse oximetry (as reference test).
  
  
  RESULTS
  150 patients with the mean age of 58.52 ± 1.73 years were included (56.6% male). Sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratio of tracheal ultrasonography in endotracheal tube confirmation were 96 (95% CI: 92-99), 88 (95% CI: 62-97), 98 (95% CI: 94-99), 78 (95% CI: 53-93), 64 (95% CI: 16-255), and 0.2 (95% CI: 0.1-0.6), respectively.
  
  
  CONCLUSIONS
  The present study showed that tracheal ultrasonography by trained emergency medicine residents had excellent sensitivity (>90%) and good specificity (80-90) for confirming endotracheal tube placement. Therefore, it seems that ultrasonography is a proper screening tool in determining endotracheal tube placement.
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Zamani Moghadam
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohamad Davood
authors.initials: MD
authors.lastname: Sharifi
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hasan
authors.initials: H
authors.lastname: Rajabi
authors.affiliation: Department of Social Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Mousavi Bazaz
authors.affiliation: Department of Radiology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Alamdaran
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Niazmohammad
authors.initials: N
authors.lastname: Jafari
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Seyed Amir Masoud
authors.initials: SA
authors.lastname: Hashemian
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Talebi Deloei
keywords: Ultrasonography; airway management; emergency service; hospital; intratracheal; intubation