However, the success rate of correct ETT placement for junior medical staff is less than 50%, and accidental esophageal intubation
is common (4).
Life-threatening ETI-associated complications, such as cardiac arrest after an ETI attempt, failed intubation salvaged by emergency surgical airway, and esophageal intubation
with delayed recognition, occurring in either the prehospital or ED setting, are peer-reviewed, confirmed by experienced anesthesiologists, and recorded in the quality assurance database.
Adverse Events Number of % n* 95% CI Patients Airway trauma 2 3.3 0.3%-11.9% Cardiac arrest 10 16.4 9.0%-27.8% Dysrhythmia 3 4.9 1.1%-14.0% Esophageal intubation
2 3.3 0.3%-11.9% (delayed recognition) Esophageal intubation
2 3.3 0.3%-11.9% (immediate recognition) Hypotension 13 21.3 12.8%-33.3% Hypoxia 36 59.0 46.5%-70.5% Main-stem intubation 5 8.2 3.2%-18.2% Tachy-dysrhythmia 1 1.6 0.0%-9.6% Vomiting 6 9.8 4.3%-20.2% * Percentages do not total 100% as some patients experienced multiple adverse events.
They found that, in patients with a Cormack-Lehane class 3 or 4, UEscope was associated with significantly decreased times to laryngeal visualization and intubation, increased FAIS, and reduced incidences of traumatic airway complications and unintentional esophageal intubation
. Furthermore, the results obtained by Pan et al .[sup] in 40 patients with a Cormack-Lehane class 3 or 4 and undergoing emergency intubation are the same as the findings of Wang et al .' study.[sup]
is a frequently encountered problem in emergency medicine, and the frequency of esophageal intubation
has been increasing because of pre-hospital interventions, pediatric patients, and inexperienced personnel (45).
This review discusses the role of ultrasound as an additional complementary tool in the management of the airway in different situations, including the identification of structures, detection of esophageal intubation
, positioning of the endotracheal tube, proper size selection of the conventional and double-lumen endotracheal tube, determination of adequate face mask or supraglottic device ventilation, difficult airway predictors, predictors of risk of postextubation stridor, and ultrasound-guided translaryngeal techniques, including translaryngeal blocks, retrograde intubation and percutaneous tracheostomy.