Portable Handheld Point-of-Care Ultrasound for Detecting Unrecognized Esophageal Intubations

Esophageal intubations are not an uncommon occurrence in prehospital settings, occurring as high as 17%. These never events are associated with significant morbidity and mortality especially when unrecognized or when there is delayed recognition. Here, we review the currently available techniques for confirming endotracheal tube intubation and their limitations, and present the case for the application of portable handheld point-of-care ultrasound as an emerging technology for detection of potentially unrecognized esophageal intubations such as during cardiac arrest. We also provide algorithms for confirmation of tracheal intubation.

Automated summary

Esophageal intubations are common in prehospital settings, and can lead to significant morbidity and mortality if unrecognized or delayed in recognition. This article reviews the available techniques for confirming tracheal intubation and proposes the use of portable handheld point-of-care ultrasound as an emerging technology for detecting unrecognized esophageal intubations, particularly during cardiac arrest.