If the XR tech is busy with the traumas, its the overnight shift where resources are limited, and you just intubated someone who didnt have great breath sounds or O2 sat to begin with – and want to assess if the ETT is in the trachea – cool way to do it. Linear probe. transverse over the trachea at the jugular notch. You will see the the trachea as an arched hyperechoic (bright linear) structure with tracheal rings coming down from it. With the ETT in the trachea, a shadow of the tube over the trachea will be seen, but that may be tough to see at times, so you can put the color doppler box over it and do a little – wiggle wiggle wiggle wiggle wiggle, yeah – of the ETT – a color ray will spike down from the trachea.
ETT in the esophagus? (oopsy!). First off, you will see a shadow coming from the esophagus (illustrating the ETT) which most of time is on the patient’s left side and normally only seen if collapsed (your right when looking at the screen). It will look like you have 2 tracheas next to each other! When a color doppler box is over it, and you give the ETT a little wiggle wiggle wiggle wiggle wiggle, yeah (yes, had to give props again to LMFAO), a ray will come from the esophagus – and then you know… blame it on someone else, and you have to try again.
SonoSpot: Topics in Bedside Ultrasound 