Evaluation of the rapid airway assessment ultrasound protocol for confirming endotracheal intubation

<bold>Introduction:</bold> Endotracheal intubation is a critical procedure in airway management; however, complications may arise due to the malposition. Airway ultrasound emerges as a non-invasive, rapid and efficient method. The Rapid Airway Assessment ultraSound (RAAS) protocol was developed to confirm the success of endotracheal intubation. <bold>Objective:</bold> to evaluate the success of intubation. <bold>Methods:</bold> A prospective observational study was conducted on patients undergoing endotracheal intubation. Each patient underwent an assessment to determine the success of intubation, which included airway ultrasound using the RAAS protocol, and bronchoscopy. Successful intubation is defined by 3 components: 1. positioning within the trachea, 2. appropriate depth, and 3. absence of complications. <bold>Results:</bold> Among the 80 patients who underwent intubation, the success rate was 91.3%. All cases demonstrated successful tracheal intubation (100%), appropriate depth (91.3%), and an absence of complications. RAAS protocol revealed a 100% absence of the double tract sign and identified the bilateral lung sliding sign. The cricoid and proximal edge of endotracheal cuff distance (CCD) was 1.17±0.30 cm. In the successful intubation group, the average CCD was 1.13±0.13 cm. CCD is inversely proportional to the depth of the endotracheal tube. CCD and the patient's height are correlated with the depth of the endotracheal tube and are statistically significant (p-value<0.001). Endotracheal depth=0.057–1.840(CCD)+0.042(Height). The equation was statistically significant (F0.05(2,77)=30.15, p-value<0.001), with a coefficient of determination of 0.439. <bold>Conclusion:</bold> the RAAS protocol can evaluate the success of intubation.