Which technique provides the most reliable immediate confirmation of endotracheal tube placement?

Which technique provides the most reliable immediate confirmation of endotracheal tube placement?

• A. Auscultation
• B. Pulse oximetry
• C. Chest radiography
• D. Capnography

Answer: (D)

Detecting CO2 in exhaled air with capnography gives real-time proof that the tube is in the trachea. The capnograph produces a waveform with each breath and a numerical end-tidal CO2 value, typically around 35–40 mmHg in a normal patient. If the tube is in the esophagus, CO2 is not detected and the trace is absent or flat, signaling immediate misplacement and the need to reposition. This immediate, breath-by-breath confirmation is more reliable than listening with a stethoscope, which can be fooled by noisy environments or concurrent chest/abdominal conditions; oxygen saturation monitoring reflects oxygenation and may lag behind placement; chest radiography confirms position but takes time and isn’t instantaneous. Capnography provides the fastest and most dependable confirmation of correct endotracheal tube placement.

Detecting CO2 in exhaled air with capnography gives real-time proof that the tube is in the trachea. The capnograph produces a waveform with each breath and a numerical end-tidal CO2 value, typically around 35–40 mmHg in a normal patient. If the tube is in the esophagus, CO2 is not detected and the trace is absent or flat, signaling immediate misplacement and the need to reposition. This immediate, breath-by-breath confirmation is more reliable than listening with a stethoscope, which can be fooled by noisy environments or concurrent chest/abdominal conditions; oxygen saturation monitoring reflects oxygenation and may lag behind placement; chest radiography confirms position but takes time and isn’t instantaneous. Capnography provides the fastest and most dependable confirmation of correct endotracheal tube placement.