Journal scan 2: May 2014

Digital palpation of endotracheal tube tip as a method of confirming endotracheal tube position in neonates: an open-label, three-armed randomized controlled trial. Saboo AR, Dutta S, Sodhi KS. Pediatric Anesthesia 23 (2013) 934–939

After neonatal intubation, chances of dislocation of the tracheal tube  are fairly high. A technique was studied at PGIMER, India involving palpation of the tube tip in the suprasternal notch. This is a small but interesting study.

Design: The chances of malposition after insertion length based on a weight-based nomogram against malposition after insertion based on palpation of tube in suprasternal notch was studied.
The suprasternal notch was chosen because it anatomically corresponds to vertebral level T2, close to the optimal position at the mid-tracheal point. Correct position on the chest radiograph was defined as any position <0.5 cm above the interclavicular midpoint and more than 1 cm above the carina.

Conclusions: The authors concluded that Suprasternal palpation shows promise as a simple, safe, and teachable method of confirming ETT position in neonates.
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