What should be assessed to verify endotracheal (ET) tube placement?

To verify the placement of an endotracheal (ET) tube, assessing end-tidal carbon dioxide levels is the most reliable method. When an ET tube is correctly placed in the trachea, it will allow for the effective ventilation of the lungs, leading to the exhalation of carbon dioxide. The measurement of end-tidal carbon dioxide (ETCO2) provides real-time feedback about the patient’s ventilation status.

When the ET tube is in the correct position, the capnography device will show a consistent ETCO2 waveform and appropriate levels, indicating that gases are being exchanged in the lungs. If the tube is misplaced (for example, in the esophagus), the CO2 levels would be significantly lower or nonexistent since there would not be effective gas exchange occurring in the lungs.

Other assessments, such as respiratory rate or supplemental oxygen saturation, while important for overall patient evaluation, do not provide as definitive an indication of ET tube placement as ETCO2 levels do. Heart sounds are also not related to verifying ET tube placement and do not reflect the function of the airway. Therefore, end-tidal carbon dioxide levels are the gold standard for confirming that the tube is correctly positioned in the trachea.