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Saudi J Anaesth. 2017 Apr-Jun; 11(2): 236.
PMCID: PMC5389248

Sonographic detection of tracheal or esophageal intubation: A cadaver study

Sir,

A 36-year-old male patient with a road traffic accident as a pedestrian was planned to be referred into the Intensive Care Unit (ICU) after performing the brain and thorax computed tomography (CT) scans due to severe head and thorax trauma. Before radiology department, the patient was intubated after the administration of rocuronium 40 mg and propofol 200 mg in the Emergency Care Unit. On sudden deterioration during CT scan, the patient was immediately brought into our ICU. At admission, he had cyanosis lacking chest expansion and respiratory sounds with a saturation of 15%. Immediate direct laryngoscopy was performed where the tube placed into the esophagus was inserted into the trachea. The place of the tube was confirmed by bilateral respiratory sounds, chest expansion, elevated saturation, and observation of carbon dioxide in capnography and ultrasonography. Evaluations of the CT scans after stabilization of the patient revealed placement of the endotracheal tube in the esophagus [Figure 1].

Figure 1
Computed tomography view of neck (thin arrow shows trachea, thick arrow shows esophagus)

Tejesh et al. suggested ultrasonography as a simple, easy-to-use, and noninvasive method for the verification of place of endotracheal tube in their study where they tested such usage. By presenting our case of esophageal intubation attempt which was noticed relatively late, we would like to make a contribution to the known benefits of ultrasonography by showing its early visualizing ability of the place of the endotracheal tube.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


Articles from Saudi Journal of Anaesthesia are provided here courtesy of Wolters Kluwer -- Medknow Publications