Question

When verifying ET tube placement on a perfusing patient, the 'gold standard' of monitoring is considered to be?

1) Colorimetric carbon dioxide detector
2) Pulse oximetry
3) Listening to lung sounds
4) Waveform capnography

Answer 1

The 'gold standard' for verifying ET tube placement in a perfusing patient is waveform capnography. It allows for real-time monitoring of exhaled CO2 levels, confirming correct placement and adequate pulmonary blood flow.

4) Waveform capnography

Step-by-step explanation:

When verifying ET tube placement on a perfusing patient, the 'gold standard' of monitoring is considered to be waveform capnography. This method provides continuous and real-time monitoring of the carbon dioxide levels in the exhaled breath, which is especially important for confirming correct endotracheal tube placement. A rise in end-tidal CO2, represented as a waveform, confirms that the tube is placed in the trachea and that there is adequate circulation and pulmonary blood flow to transport CO2 to the lungs for expiration.

While other methods such as listening to lung sounds or using colorimetric CO2 detectors can provide initial confirmation of ET tube placement, waveform capnography offers continuous verification, which is crucial in dynamic clinical settings where tube displacement can occur. Pulse oximetry, though important for monitoring oxygenation, does not directly confirm ET tube placement and may not immediately reflect inadvertent displacement or misplacement into the esophagus, given its reliance on peripheral oxygen saturation rather than CO2 emission.