Real Time Point of care Ultrasonography versus Auscultation for the confirmation of Endotracheal versus Bronchial Intubation in Emergency Department

Aims and objectives To study the accuracy of real time point of care ultrasonography (POCUS) in confirming the endotracheal tube position during emergency intubations. Method This was a prospective randomized controlled study done in the Department of Emergency Medicine at SS Institute of Medical Sciences and Research Centre (SSIMS& RC), Davangere, Karnataka, India. Three residents (one for endotracheal intubation, one for POCUS, one for auscultation) and a consultant emergency physician trained in POCUS conducted the study to determine the accuracy of POCUS. The residents were blinded to share their findings. Result1) The study showed that the sensitivity of POCUS is 94.6 % and specificity is 86.5 % in determining the position of ETT whether it was in trachea or right main bronchus whereas the auscultation showed the sensitivity of 82.7 % and specificity of 57.7 % for the same.2) The study showed that the sensitivity of POCUS is 97.6 % and specificity is 81 % in determining the position of ETT whether it was in trachea or left main bronchus whereas the auscultation showed the sensitivity of 92.4 % and specificity of 62 %for the same. Conclusion The present study proved that the Real Time Point of Care Ultrasonography is more accurate than auscultation in determining the position of endotracheal tube during emergency intubations.