Poster or Presentation Title

Use of Ultrasound by Physician Assistant Students with Minimal Ultrasound Training as a Means of Static Endotracheal Intubation Confirmation

Access Type

Open Access

Presentation Type

Poster Presentation

Start Date

April 2017

End Date

April 2017

Department

Physician Assistant

Abstract

Early identification of errant endotracheal tube (ETT) placement is of utmost importance, as unrecognized esophageal intubations are associated with significant patient morbidity and mortality. Several confirmatory methods exist to identify ETT location, but none have proven ideal in all circumstances. Recent studies have determined the viability of ultrasound for confirming ETT location, when conducted by healthcare providers with advanced ultrasound training. The purpose of this study is to determine whether Physician Assistant (PA) students with minimal ultrasound training are able to correctly identify static ETT location using ultrasound following a 10 minute didactic presentation. This was a prospective, single-blinded study conducted using human cadaver models. In this study, first-year PA students were given a 10 minute didactic presentation on the suprasternal ultrasound technique and identifying relevant anatomy. Participants were then asked to identify the ETT location in two human cadavers using the described technique. Of the 23 students invited to participate, 20 completed the study resulting in a 87.00% participation rate. The sensitivity, specificity, positive predictive value, and negative predictive value for determining the correct location of the ETT were 85.00% (95% confidence interval (CI), 69.73-100%), 80.00% (62.89-97.11%), 80.95% (64.25-97.65%), and 84.21% (68.61-99.81%), respectively. It was found that PA students with minimal ultrasound training were able to utilize ultrasound to accurately determine ETT location, following a 10 minute presentation. These findings are congruent with those of previous studies aimed at decreasing morbidity and mortality associated with esophageal intubations.

Faculty Mentor

Jeremy Welsh, Eric Schmidt, Joyce S. Nicholas, W. Joesph Bowman

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Use of Ultrasound by Physician Assistant Students with Minimal Ultrasound Training as a Means of Static Endotracheal Intubation Confirmation

Early identification of errant endotracheal tube (ETT) placement is of utmost importance, as unrecognized esophageal intubations are associated with significant patient morbidity and mortality. Several confirmatory methods exist to identify ETT location, but none have proven ideal in all circumstances. Recent studies have determined the viability of ultrasound for confirming ETT location, when conducted by healthcare providers with advanced ultrasound training. The purpose of this study is to determine whether Physician Assistant (PA) students with minimal ultrasound training are able to correctly identify static ETT location using ultrasound following a 10 minute didactic presentation. This was a prospective, single-blinded study conducted using human cadaver models. In this study, first-year PA students were given a 10 minute didactic presentation on the suprasternal ultrasound technique and identifying relevant anatomy. Participants were then asked to identify the ETT location in two human cadavers using the described technique. Of the 23 students invited to participate, 20 completed the study resulting in a 87.00% participation rate. The sensitivity, specificity, positive predictive value, and negative predictive value for determining the correct location of the ETT were 85.00% (95% confidence interval (CI), 69.73-100%), 80.00% (62.89-97.11%), 80.95% (64.25-97.65%), and 84.21% (68.61-99.81%), respectively. It was found that PA students with minimal ultrasound training were able to utilize ultrasound to accurately determine ETT location, following a 10 minute presentation. These findings are congruent with those of previous studies aimed at decreasing morbidity and mortality associated with esophageal intubations.