[Methods for ensuring correct tracheal intubation. A review]

Abstract

To confirm correct intubation of the trachea, the literature mentions the following methods: Auscultation of thorax, the sensation of normal ventilation, gastric and thorax movement, condensation of water vapor in the tube lumen, external palpation on the patient's neck of the tube and the cuff, tactile palpation through the patient's mouth of the tube, x-ray of thorax and detection of hemoglobin oxysaturation with pulse oximetry. These methods can be used, but cannot be recommended, because they are not reliable. The following methods are recommended in the literature as reliable: Repeated laryngoscopy when there are direct visualization of the vocal cords, fiberoptic bronchoscopy, suction on the tube with a 60-ml syringe, auscultation of the upper abdomen and lungs and end-tidal carbon dioxide measurement. For the daily routine, control, of the endotracheal tube placement, by auscultation over the epigastrium, then in the right and left axilla, and continuous measurement of carbon dioxide in the expired air are recommended.