Learning Curve for Interpreting Transtracheal Ultrasound Images to Confirm Endotracheal Tube Placement Among Anaesthesia Residents in a Teaching Hospital

Objectives

Airway ultrasound is a promising tool that can be used alongside capnography to confirm correct endotracheal tube (ETT) placement. This study aimed to quantify the practice required to achieve accurate interpretation of trans-tracheal ultrasound for identifying ETT placement during elective surgeries under general anaesthesia in a teaching hospital.

Methods

Thirty-six anaesthesia residents participated. A baseline ultrasound image interpretation test was conducted, followed by a short video tutorial on upper airway ultrasound. Participants then completed a post-test to identify 10 clips/images in a single attempt. Pre- and post-tutorial scores, time taken for interpretation and confidence levels were compared using Wilcoxon signed rank test. Statistical significance was set at p < 0.05.

Results

All 36 residents (55.6% female, mean age 29.1 ± 1.81 years) completed the study. After a video tutorial, the median interpretation score improved significantly from 3 (2) to 10 (0) (p < 0.001), and the median interpretation time decreased from 12.9 (4.7) to 4.6 (1.2) s (p < 0.001). Confidence levels also improved significantly. Proficiency was achieved by 91.7% (33/36) of participants after one practice attempt, with the remaining 8.3% succeeding after a second attempt.

Conclusions

A brief tutorial on airway ultrasound significantly improves anaesthesia residents' ability to interpret ultrasound images for endotracheal tube placement. It may serve as a valuable adjunct to traditional methods for ETT placement confirmation.