What is the confirmation process for endotracheal intubation?

The confirmation process for endotracheal intubation is best achieved through a combination of techniques, with the visualization of the endotracheal tube (ETT) passing through the vocal cords being a critical first step. This ensures that the tube is correctly positioned within the trachea, rather than the esophagus or in the wrong airway.

In addition to visual confirmation, continuous capnography (EtCO2 monitoring) plays an essential role in confirming proper placement. The presence of CO2 in exhaled breath at the correct levels indicates that the ETT is in the trachea and allows for real-time assessment of ventilation. This dual confirmation approach significantly increases the reliability of confirming proper intubation, as it mitigates the risk of misplaced tubes.

Other methods, such as auscultation or reliance solely on visualizing structures without monitoring, may not provide complete assurance of correct placement and can lead to complications if the tube is not appropriately positioned. Thus, incorporating both visual confirmation and EtCO2 monitoring is the most comprehensive and effective method for confirming endotracheal intubation.