Ultrasound for airway management : An evidence-based review for the emergency clinician

Copyright © 2019 Elsevier Inc. All rights reserved..

BACKGROUND: Airway management is a common procedure performed in the Emergency Department with significant potential for complications. Many of the traditional physical examination maneuvers have limitations in the assessment and management of difficult airways. Point-of-care ultrasound (POCUS) has been increasingly studied for the evaluation and management of the airway in a variety of settings.

OBJECTIVE: This article summarizes the current literature on POCUS for airway assessment, intubation confirmation, endotracheal tube (ETT) depth assessment, and performing cricothyroidotomy with an emphasis on those components most relevant for the Emergency Medicine clinician.

DISCUSSION: POCUS can be a useful tool for identifying difficult airways by measuring the distance from the skin to the thyrohyoid membrane, hyoid bone, or epiglottis. It can also predict ETT size better than age-based formulae. POCUS is highly accurate for confirming ETT placement in adult and pediatric patients. The typical approach involves transtracheal visualization but can also include lung sliding and diaphragmatic elevation. ETT depth can be assessed by visualizing the ETT cuff in the trachea, as well as using lung sliding and the lung pulse sign. Finally, POCUS can identify the cricothyroid membrane more quickly and accurately than the landmark-based approach.

CONCLUSION: Airway management is a core skill in the Emergency Department. POCUS can be a valuable tool with applications ranging from airway assessment to dynamic cricothyroidotomy. This paper summarizes the key literature on POCUS for airway management.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:38

Enthalten in:

The American journal of emergency medicine - 38(2020), 5 vom: 10. Mai, Seite 1007-1013

Sprache:

Englisch

Beteiligte Personen:

Gottlieb, Michael [VerfasserIn]
Holladay, Dallas [VerfasserIn]
Burns, Katharine M [VerfasserIn]
Nakitende, Damali [VerfasserIn]
Bailitz, John [VerfasserIn]

Links:

Volltext

Themen:

Airway, intubation
Cricothyroidotomy
Endotracheal
Journal Article
Review
Ultrasound

Anmerkungen:

Date Completed 11.08.2020

Date Revised 11.08.2020

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.ajem.2019.12.019

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM304442925