Confirming ET Tube Placement with Ultrasound
An indirect method for assessing proper placement of the ET tube is to watch the pleura for the presence of the slide sign. The pleura are easily identified from the anterior chest wall utilizing the high-frequency transducer. The transducer should be placed just inferior to the clavicle in the mid-clavicular line. Pointing the indicator toward the patient’s head will produce an image that is easy to interpret. Once the skin, soft tissue, and ribs have been identified, the pleura will be seen as a hyperechoic (white) line running just deep to the rib. In real time, the pleura slide back and forth with respiration.
Christine Butts, MD