Question

You have intubated an apneic patient and auscultate breath sounds. Breath sound are absent over the epigastrium and present bilaterally over the lungs. What is the next mandatory confirmation?

Answer 1

The next step after auscultation is confirming end-tidal CO2 (ETCO2) to ensure that the intubation tube is placed correctly and there is effective gas exchange.

Step-by-step explanation:

After intubating an apneic patient and confirming that breath sounds are absent over the epigastrium and present bilaterally over the lungs, the next mandatory confirmation of correct tube placement is to verify end-tidal CO2 (ETCO2) with a capnograph or a colorimetric device. This ensures that the tube is indeed in the trachea and not the esophagus and that there is effective exchange of gases. ETCO2 monitoring provides a continuous, non-invasive measure of the carbon dioxide partial pressure during the breathing cycle. A colour change indicates the presence of exhaled carbon dioxide, thus confirming tracheal placement. This step is crucial as it ensures that the patient is receiving adequate ventilation and oxygenation.