Prehospital Trauma Life Support (PHTLS) Practice Test

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What is the most reliable method for verifying endotracheal tube placement?

Pulse oximetry
End-tidal capnometry
Syringe aspiration
None of the above

The correct answer is: None of the above

The most reliable method for verifying endotracheal tube placement is end-tidal capnometry. This technique measures the concentration of carbon dioxide in exhaled air and provides immediate feedback on whether the tube is correctly placed in the trachea. If the tube is in the correct position, there will be a detectable level of carbon dioxide, as opposed to if it is in the esophagus, where there would be little to no carbon dioxide because that area does not participate in gas exchange. Pulse oximetry, while valuable for assessing oxygen saturation, does not confirm tube placement directly. It only reflects the patient’s oxygen status, which may be misleading if the tube is not positioned properly. Syringe aspiration, which involves pulling back on a syringe attached to the endotracheal tube to collect fluid, is not a standardized or reliable method for confirming placement and is generally not used. Thus, end-tidal capnometry stands out as the preferred and most effective method for direct confirmation of endotracheal tube placement because it provides real-time information that relates specifically to the tube's position in the airway.