hello my name is Tom Cook and I'm going to talk to you today about using ultrasound to check for the placement of an ENT tral tube obviously if you're an Emergency Physician or critical care specialist this could come in quite handy when you get done intubating somebody you're not quite sure if the endot tral tube is in the correct place so to demonstrate this exam we're going to be using clarice's new probe this is the pal HD3 pal is an acrm for phased aray and linear it's a fantastic new tool allows you to examine almost every area of the body with a single probe we're going to put it in a linear Ray mode and we're going to set it to small organs we're going to be looking right here at the neck and the first thing we're going to do is take an axial cut of the neck right here over the vocal cords and just to show that I'm going to ask my model to say e e and you can see the vocal folds moving one more time e so those are the vocal folds and what we're going to do from here is come down just a little a little bit and now we're over the tracheal rings and you can see one there and then you'll see another one there and so forth and so on and when you intubate the patient if the interrical tube is in the correct place you'll see uh evidence of the tube in there with shadowing because obviously the tube is full of air and you'll get a big Shadow artifact but if for some reason you're in the esophagus what you'll do is come over here and look at the left lateral lobe of the thyroid and if you look just below the lobe you'll see where the esophagus is located and you'll pick up an air artifact just under the left lobe of the thyroid and uh you can see it's position here I can pull this around and you can actually say this is the longitudinal view of the esophagus so once again really quick and easy way to check for intrical tube placement sensitivities are Almost 100% in every single case very very simple thing to do encourage you to put it in your little tool bag and sometimes you'll pull it out and really help you out in a tough situation
