Test yourself
Intubation check: spot the double tract
5 questions. Pick an answer to see whether you are right and why. Your score appears at the end.
Question 1What is the double tract sign?
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Answer a. When the tube enters the oesophagus, air inside it creates a second bright curved line with reverberation, beside the trachea. Two air shadows mean the tube is in the wrong place.
Question 2Where does the oesophagus usually lie in a transverse view above the suprasternal notch?
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Answer c. The oesophagus usually sits posterolateral to the trachea on the left. Find it before intubation so you know where to look for a second tract.
Question 3Which test remains the standard for confirming tracheal tube placement?
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Answer c. Sustained waveform capnography is the standard. Ultrasound adds a direct look, especially when capnography is limited during cardiac arrest. Auscultation and misting are unreliable.
Question 4What does neck ultrasound not tell you about the tube?
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Answer c. The neck view shows whether the tube is in the trachea or the oesophagus. It does not show the tip position. Check lung sliding on both sides to detect a main bronchus intubation.
Question 5After intubation, the right chest shows sliding and the left shows a lung pulse with no sliding. What is the most likely cause?
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Answer d. A lung pulse shows the left lung lies against the chest wall but is not ventilating. With sliding on the right, the tube most likely sits in the right main bronchus. Withdraw it slightly and rescan.
Practise it with us
Four or five delegates per instructor, FAMUS-accredited faculty and long, supervised time on the probe.
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