A 45-year-old man was brought to the hospital 40 minutes after being shot in the abdomen with a 0.38-caliber handgun. Upon arrival, the patient was conscious and alert. Blood pressure: 77/50 mm Hg Pulse: 143 beats/minute Respiratory rate: 30 breaths/minute Pulse oximetry of 72% initially on room air Chest X-rays showed bilateral pneumothoraces with partial lung collapse. Rapid sequence induction (RSI) was begun with an 8-mm Endotracheal tube (ETT). Bilateral chest tubes were inserted.
The patient was started on pressure support of +10 mm Hg with 0 PEEP and Fl02 of 100%. Additional chest X-rays and blood gas determinations were pending. You, as the doctor, don’t wish to wait for an X-ray and want to ensure that ETT is in the trachea and endotracheal intubation (ETI) is properly placed. What will be the most reliable confirmation of proper tracheal placement of ETI at that moment? (The…
